NPI 1114591203 · live from the CMS NPI Registry
Taylor Wayne Brooks Blackwood, DO
Orthopaedic Surgery in Bermuda Run, NC. National Provider Identifier 1114591203, active.
NPI record
| NPI | 1114591203 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Orthopaedic Surgery 207X00000X |
| Practice location | 419 Twins Way, Bermuda Run, NC 27006 |
| Practice phone | 336-716-8091 |
| Mailing address | 2556 Stadium Dr, Fort Worth, TX 76109 |
| Enumerated | May 13, 2021 |
| Last updated | September 11, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Orthopaedic Surgery primary | 207X00000X | 2026-00894 (NC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.