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General NPI Number Information
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NPI Number | 1184807406
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Entity Type | Organization
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Legal Business Name | JAMES E. TAYLOR MEDICAL PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 12/10/2007
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Last Update Date | 02/22/2008
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Provider Practice Location Address
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Address Line | 2102 EVANS AVE SUITE 111
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City | VALPARAISO
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State | IN
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Zip | 46383-4095
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Country | US
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Telephone | 219-464-9521
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Fax |
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Provider Business Mailing Address
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Address Line | 2102 EVANS AVE SUITE 111
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City | VALPARAISO
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State | IN
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Zip | 46383-4095
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Country | US
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Telephone | 219-464-9521
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES E TAYLOR
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Credential | M.D.
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Telephone | 219-464-9521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 01021583
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License Number State | IN
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