Marcellus O Taylor, PH. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 5184 Issued in FL

Practice address

2998 Vortec Rd
Marianna, FL 32446-6734

Phone

(850) 209-2643

NPI assigned

Mar 31, 2009

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1407098841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 LAFAYETTE ST",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324463405",
            "telephone_number": "850-209-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2998 VORTEC RD",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324466734",
            "telephone_number": "850-209-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MARCELLUS",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "PH. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-31",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 5184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59690",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tallahassee Orthopedic Clinic III PL
• Tallahassee Orthopedic Clinic III, PL
• L Tan, M.D.
• Heather Lynn Tatum, ARNP
• Justin Taylor
• Andra Kay Temples, P.T.
• Lee J Temples
• Alyssa Terry, MS, CF-SLP
• Vicki Parish Tew, ARNP
• The Doctors' Office, P.a.

• Clinical Psychologist in Marianna, FL
• Providers in Marianna, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.