Healthcare Provider Details

I. General information

NPI: 1639209646
Provider Name (Legal Business Name): TAYLOR & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N COLLEGE ST
MOUNTAIN HOME AR
72653-3654
US

IV. Provider business mailing address

202 N COLLEGE ST
MOUNTAIN HOME AR
72653-3654
US

V. Phone/Fax

Practice location:
  • Phone: 870-424-4600
  • Fax: 870-424-6950
Mailing address:
  • Phone: 870-424-4600
  • Fax: 870-424-6950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA181
License Number StateAR

VIII. Authorized Official

Name: MATTHEW A TAYLOR
Title or Position: PRESIDENT
Credential: AUD
Phone: 870-424-4600