MEDICARE: TAYLOR PAGE DUPLESSIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171000000X	Military Health Care Provider	33849	NE
2	208000000X	Pediatrics Physician	33849	NE

General Provider Information

NPI Number	:	1275030942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR PAGE DUPLESSIS MD

Provider Business Mailing Address
First Line	:	4076 NEELY ROAD
Second Line	:
City	:	FORT WAINWRIGHT
State	:	AK
Zip	:	99703
Country	:	US
Telephone Number	:	907-361-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	9040 JACKSON AVE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98431-1702
Country	:	US
Telephone Number	:	253-968-0117
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	08/06/2024

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Directions to “ TAYLOR PAGE DUPLESSIS MD” Practice Location

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