Provider Demographics
NPI:1427050210
Name:TAYLOR, JEFFREY LANE (OD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LANE
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4295 E US HIGHWAY 64 ALT
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-6846
Mailing Address - Country:US
Mailing Address - Phone:828-837-1000
Mailing Address - Fax:828-837-1100
Practice Address - Street 1:4295 E US HIGHWAY 64 ALT
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6846
Practice Address - Country:US
Practice Address - Phone:828-837-1000
Practice Address - Fax:828-837-1100
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1607152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909838Medicaid
NC410040699OtherRAILROAD MEDICARE
NC5501380002Medicare NSC
NC2470023AMedicare PIN
NC410040699OtherRAILROAD MEDICARE
NCU57499Medicare UPIN