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NPI Code Detail

MEDICARE: TAYLOR HALL

MEDICARE: TAYLOR HALL
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
1363A00000XPhysician Assistant15-02538KS

General Provider Information

NPI Number : 1558939991
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR HALL
Provider Business Mailing Address
First Line : 1811 WAKARUSA DR STE 102
Second Line :
City : LAWRENCE
State : KS
Zip : 66047-2082
Country : US
Telephone Number : 785-371-4921
Fax Number :
Provider Business Practice Location Address
First Line : 1811 WAKARUSA DR STE 102
Second Line :
City : LAWRENCE
State : KS
Zip : 66047-2082
Country : US
Telephone Number : 785-371-4921
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2021
Last Update Date : 04/24/2023

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Directions to “ TAYLOR HALL ” Practice Location

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