Provider Demographics
NPI:1457760720
Name:TAYLOR, KEVIN ALLEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ALLEN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1971 S BRANNON STAND RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-7180
Mailing Address - Country:US
Mailing Address - Phone:334-446-5300
Mailing Address - Fax:334-446-3122
Practice Address - Street 1:1971 S BRANNON STAND RD
Practice Address - Street 2:SUITE 1
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-7180
Practice Address - Country:US
Practice Address - Phone:334-446-5300
Practice Address - Fax:334-446-3122
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46468183500000X
AL17650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist