| Hubert D Taylor Ii, DO | |
|
960 Avent Dr, Grenada, MS 38901-5230 | |
| (662) 227-7000 | |
| Not Available |
| Full Name | Hubert D Taylor Ii |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 960 Avent Dr, Grenada, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619292307 | NPI | - | NPPES |
| P01560408 | Other | MS | RAILROAD MEDICARE |
| 08305840 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 21117 (Mississippi) | Primary |
| 207P00000X | Emergency Medicine | 34-009791 (Ohio) | Secondary |
| Entity Name | State Of Mississippi-university Of Mississippi Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154317527 PECOS PAC ID: 1850293036 Enrollment ID: O20090414000575 |
| Entity Name | Grenada Emergency Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1194388082 PECOS PAC ID: 2163854225 Enrollment ID: O20191112001896 |
| Mailing Address | Practice Location Address |
|---|---|
| Hubert D Taylor Ii, DO 960 Avent Dr, Grenada, MS 38901-5230 Ph: (662) 227-7000 | Hubert D Taylor Ii, DO 960 Avent Dr, Grenada, MS 38901-5230 Ph: (662) 227-7000 |
Dr. Tarence E Wade, MD Emergency Medicine Medicare: May Accept Medicare Assignments Practice Location: 960 Avent Dr, Grenada, MS 38901 Phone: 662-227-7172 | |
Dr. Dennis W Aust, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 960 Avent Dr, Grenada, MS 38901 Phone: 800-424-3672 Fax: 954-377-3042 | |
Dr. Stephen D Butler, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 960 Avent Dr, Grenada, MS 38901 Phone: 662-227-7172 |