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General NPI Number Information
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NPI Number | 1588313092
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Entity Type | Individual
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Provider Name | TAYLOR M GILLIS MD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 150 MERCURY VILLAGE DR
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City | DURANGO
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State | CO
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Zip | 81301-8955
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Country | US
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Telephone | 970-335-2342
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27128
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City | SALT LAKE CITY
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State | UT
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Zip | 84127-0128
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Country | US
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Telephone | 801-786-7500
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Fax | 801-786-7555
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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 | DR.0075456
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License Number State | CO
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