Healthcare Provider Details

I. General information

NPI: 1336039791
Provider Name (Legal Business Name): TAYLOR JAMES SPEARS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TAYYLOR SPEARS

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 PRIVATE DRIVE 1211
PROCTORVILLE OH
45669-8196
US

IV. Provider business mailing address

25 PRIVATE DRIVE 1211
PROCTORVILLE OH
45669-8196
US

V. Phone/Fax

Practice location:
  • Phone: 740-716-1118
  • Fax:
Mailing address:
  • Phone: 740-716-1118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: