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General NPI Number Information
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NPI Number | 1295844199
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Entity Type | Individual
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Provider Name | DAVID DOUGLAS TAYLOR MD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 BUNKER HILL DR
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City | AITKIN
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State | MN
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Zip | 56431-1865
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Country | US
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Telephone | 218-927-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 411 N 6TH ST # 1778
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City | EMERY
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State | SD
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Zip | 57332-2124
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Country | US
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Telephone | 317-432-0940
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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 | 40821
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License Number State | MN
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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 | 49600
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36014
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License Number State | IA
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