Basic Information
| Provider Information | |||||||||
| NPI: | 1023496734 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | JARED | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 355 S 12TH ST | ||||||||
| Address2: | APT B1 | ||||||||
| City: | COTTONWOOD | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 863263465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2087903187 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1298 W FINNIE FLAT RD | ||||||||
| Address2: | |||||||||
| City: | CAMP VERDE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 863225958 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9286395555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2015 | ||||||||
| LastUpdateDate: | 11/19/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 007740 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.