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General NPI Number Information
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NPI Number | 1710577697
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Entity Type | Individual
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Provider Name | MR. JOEL P TAGGART
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Gender | Male
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 650 HUEBNER RD
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City | FORT RILEY
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State | KS
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Zip | 66442-4030
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Country | US
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Telephone | 785-239-7293
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Fax |
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Provider Business Mailing Address
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Address Line | 711 W ELM ST
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City | RILEY
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State | KS
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Zip | 66531-9611
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Country | US
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Telephone | 785-210-6157
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 06427
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License Number State | KS
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