Healthcare Provider Details

I. General information

NPI: 1023932100
Provider Name (Legal Business Name): PATRICK R TAYLOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7278 LIBERTY RESERVE PL
POWELL OH
43065-3301
US

IV. Provider business mailing address

833 CANAL ST
DELAWARE OH
43015-4339
US

V. Phone/Fax

Practice location:
  • Phone: 740-417-1799
  • Fax:
Mailing address:
  • Phone: 740-417-1799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: