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General NPI Number Information
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NPI Number | 1235704982
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Entity Type | Individual
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Provider Name | TAYLOR CROTHERS
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Gender | Male
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 300 2ND AVE NE
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City | JAMESTOWN
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State | ND
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Zip | 58401-3373
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Country | US
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Telephone | 701-251-6000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5074
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City | SIOUX FALLS
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State | SD
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Zip | 57117-5074
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 17438
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 21002
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License Number State | ND
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