Basic Information
| Provider Information | |||||||||
| NPI: | 1053500736 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | JOEL | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 576 S. 1800 E. | ||||||||
| Address2: | |||||||||
| City: | FRUIT HEIGHTS | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8014408398 | ||||||||
| FaxNumber: | 8015856699 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 N 1900 E | ||||||||
| Address2: | 1C026 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841320006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015812417 | ||||||||
| FaxNumber: | 8015856699 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/18/2007 | ||||||||
| LastUpdateDate: | 04/08/2008 | ||||||||
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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 | 207P00000X | 6353499-1205 | UT | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.