Basic Information
Provider Information | |||||||||
NPI: | 1407898588 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | TAYLOR | ||||||||
FirstName: | ARTHUR | ||||||||
MiddleName: | M | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | DO | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 4300 B ST., SUITE #200 | ||||||||
Address2: |   | ||||||||
City: | ANCHORAGE | ||||||||
State: | AK | ||||||||
PostalCode: | 99503 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9073753355 | ||||||||
FaxNumber: | 9073753351 | ||||||||
Practice Location | |||||||||
Address1: | 4809 E THISTLE LANDING DR | ||||||||
Address2: | SUITE 100 | ||||||||
City: | PHOENIX | ||||||||
State: | AZ | ||||||||
PostalCode: | 850446498 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4802415427 | ||||||||
FaxNumber: | 4803934596 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/12/2006 | ||||||||
LastUpdateDate: | 11/02/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 11/02/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MB05179400 | NJ | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | 4511 | IA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | E-8627 | AR | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | 7940 | AK | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | 2018001213 | MO | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 208M00000X | 7940 | AK | N |   | Allopathic & Osteopathic Physicians | Hospitalist |   | 207R00000X | 07-497971-U | AZ | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
ID Information
ID | Type | State | Issuer | Description | 131516 | 01 | AZ | AHCCCS | OTHER | 1111001 | 01 | AZ | CIGNA | OTHER | AZ0225510 | 01 | AZ | BC/BS | OTHER | 70163 | 01 | AZ | PACIFICARE | OTHER | IZ3316 | 01 | AZ | HEALTHNET | OTHER |