Healthcare Provider Details

I. General information

NPI: 1508782202
Provider Name (Legal Business Name): MARK A TAFFIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 E 11TH ST
ASHLAND OH
44805-1856
US

IV. Provider business mailing address

302 E 11TH ST
ASHLAND OH
44805-1856
US

V. Phone/Fax

Practice location:
  • Phone: 419-581-6740
  • Fax:
Mailing address:
  • Phone: 419-581-6740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: