Healthcare Provider Details

I. General information

NPI: 1689377731
Provider Name (Legal Business Name): PATRICK R. TAYLOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 E 770 S
HEBER CITY UT
84032-4512
US

IV. Provider business mailing address

1090 E 770 S
HEBER CITY UT
84032-4512
US

V. Phone/Fax

Practice location:
  • Phone: 931-801-7586
  • Fax: 800-879-6556
Mailing address:
  • Phone: 931-801-7586
  • Fax: 800-879-6556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9831045-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: