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General NPI Number Information
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NPI Number | 1548721301
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Entity Type | Individual
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Provider Name | TAYLOR NEEDHAM
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Gender | Male
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 9100 W 74TH ST
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City | MERRIAM
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State | KS
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Zip | 66204-4004
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Country | US
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Telephone | 913-676-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 9100 W 74TH ST
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City | MERRIAM
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State | KS
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Zip | 66204-4004
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Country | US
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Telephone | 913-676-2000
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 94-10049
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 94-10049
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License Number State | KS
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