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General NPI Number Information
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NPI Number | 1598287054
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Entity Type | Individual
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Provider Name | TAYLOR STAUDT DPM
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Gender | Female
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Dates
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Enumeration Date | 07/16/2017
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 6601 CENTERVILLE BUSINESS PKWY STE 117
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City | DAYTON
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State | OH
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Zip | 45459-2690
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Country | US
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Telephone | 937-296-9806
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Fax | 937-296-9805
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Provider Business Mailing Address
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Address Line | 10280 GATEWAY PL UNIT 300
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City | BLUE ASH
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State | OH
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Zip | 45242-4692
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Country | US
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Telephone | 267-257-4931
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | SC006876
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License Number State | PA
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