Healthcare Provider Details
I. General information
NPI: 1427051614
Provider Name (Legal Business Name): JOHN K TAUS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/23/2005
Last Update Date: 08/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1501 N CEDAR CREST BLVD SUITE 110
ALLENTOWN PA
18104-2309
US
IV. Provider business mailing address
1501 N CEDAR CREST BLVD SUITE 110
ALLENTOWN PA
18104-2309
US
V. Phone/Fax
- Phone: 610-821-2828
- Fax: 610-821-7915
- Phone: 610-821-2828
- Fax: 610-821-7915
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | OS004614-L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: