Healthcare Provider Details

I. General information

NPI: 1437185212
Provider Name (Legal Business Name): BRIAN J TAYLOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13515 WOLFE RD SUITE C
NEW FREEDOM PA
17349-9346
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-812-2501
  • Fax: 717-416-7178
Mailing address:
  • Phone: 717-812-2501
  • Fax: 717-461-7178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD428025
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: