Healthcare Provider Details

I. General information

NPI: 1952920613
Provider Name (Legal Business Name): TAYLOR GRANT BILLINGS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 N LITCHFIELD RD STE 110
GOODYEAR AZ
85395-1214
US

IV. Provider business mailing address

4825 E NISBET RD
SCOTTSDALE AZ
85254-2248
US

V. Phone/Fax

Practice location:
  • Phone: 623-935-9494
  • Fax: 623-935-9292
Mailing address:
  • Phone: 480-463-7182
  • Fax: 480-517-6189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number05317
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number010414
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number010414
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: