Healthcare Provider Details

I. General information

NPI: 1316200876
Provider Name (Legal Business Name): BRIAN ERIC TAYLOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 475 BOX 1493
FPO AP
96350-1493
US

IV. Provider business mailing address

PSC 475 BOX 1493
FPO AP
96350-1493
US

V. Phone/Fax

Practice location:
  • Phone: 46-816-7144
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number17470
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: