Healthcare Provider Details

I. General information

NPI: 1629159785
Provider Name (Legal Business Name): DANNY JOE TAYLOR P.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 HARRISON ST
BATESVILLE AR
72501-7442
US

IV. Provider business mailing address

PO BOX 367 1004 MILLER STREET
MELBOURNE AR
72556-0367
US

V. Phone/Fax

Practice location:
  • Phone: 870-793-3999
  • Fax: 870-793-8203
Mailing address:
  • Phone: 870-368-4559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6734
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: