Healthcare Provider Details

I. General information

NPI: 1871956516
Provider Name (Legal Business Name): MICHAEL TAYLOR DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 07/01/2022
Certification Date: 07/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 MITCHELL AVE
BATESVILLE IN
47006-8909
US

IV. Provider business mailing address

PO BOX 236
BATESVILLE IN
47006-0236
US

V. Phone/Fax

Practice location:
  • Phone: 812-934-6624
  • Fax:
Mailing address:
  • Phone: 812-933-5441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO.2016
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS14993
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number02005954A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: