Healthcare Provider Details

I. General information

NPI: 1528471653
Provider Name (Legal Business Name): TAYLOR DUNCAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 05/28/2021
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 N GRAND AVE
FORT THOMAS KY
41075-1793
US

IV. Provider business mailing address

P.O. BOX 18667
ERLANGER KY
41018
US

V. Phone/Fax

Practice location:
  • Phone: 859-572-3618
  • Fax: 859-572-2326
Mailing address:
  • Phone: 859-572-3617
  • Fax: 859-572-2326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number11017616A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01076151A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number50143
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: