Healthcare Provider Details

I. General information

NPI: 1851202600
Provider Name (Legal Business Name): TAYLOR OPTOMETRY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 E PINE ST STE 105
CENTRAL POINT OR
97502-2482
US

IV. Provider business mailing address

650 E PINE ST STE 105
CENTRAL POINT OR
97502-2482
US

V. Phone/Fax

Practice location:
  • Phone: 541-664-5535
  • Fax: 541-664-7745
Mailing address:
  • Phone: 541-664-5535
  • Fax: 541-664-7745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN TAYLOR
Title or Position: PRESIDENT
Credential: O.D.
Phone: 208-569-0900