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General NPI Number Information
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NPI Number | 1598148827
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Entity Type | Organization
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Legal Business Name | TAYOR 2 ELITE SERVICES, INC.
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Dates
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Enumeration Date | 07/06/2015
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Last Update Date | 07/06/2015
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Provider Practice Location Address
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Address Line | 8011 YOUNGSTOWN SALEM RD
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City | CANFIELD
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State | OH
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Zip | 44406-9435
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Country | US
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Telephone | 330-507-0505
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Fax |
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Provider Business Mailing Address
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Address Line | 8011 YOUNGSTOWN SALEM RD
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City | CANFIELD
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State | OH
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Zip | 44406-9435
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Country | US
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Telephone | 330-507-0505
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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. DAVID BAXTER JACKSON
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Credential | M.D.
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Telephone | 330-507-0505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 35.059981
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License Number State | OH
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