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General NPI Number Information
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NPI Number | 1023496734
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Entity Type | Individual
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Provider Name | STEVEN JARED TAYLOR D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/13/2015
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 1298 W FINNIE FLAT RD
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City | CAMP VERDE
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State | AZ
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Zip | 86322-5958
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Country | US
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Telephone | 928-639-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 355 S 12TH ST APT B1
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City | COTTONWOOD
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State | AZ
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Zip | 86326-3465
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Country | US
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Telephone | 208-790-3187
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 007740
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License Number State | AZ
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