Healthcare Provider Details

I. General information

NPI: 1932246931
Provider Name (Legal Business Name): DONALD H TAYLOR P.A.-C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 03/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S HIGHWAY 160 SUITE B
PAHRUMP NV
89048-4784
US

IV. Provider business mailing address

PO BOX 129
PAHRUMP NV
89041-0129
US

V. Phone/Fax

Practice location:
  • Phone: 775-727-7800
  • Fax: 775-727-7808
Mailing address:
  • Phone: 775-727-7800
  • Fax: 775-727-7808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number555
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: