Healthcare Provider Details

I. General information

NPI: 1114337128
Provider Name (Legal Business Name): ALEXIS MAE TAYLOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 E HAMPDEN AVE STE 360
ENGLEWOOD CO
80113-3877
US

IV. Provider business mailing address

499 E HAMPDEN AVE STE 360
ENGLEWOOD CO
80113-3877
US

V. Phone/Fax

Practice location:
  • Phone: 303-781-4485
  • Fax:
Mailing address:
  • Phone: 303-781-4485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberDR0067212
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberDR0067212
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberDR0067212
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: