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General NPI Number Information
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NPI Number | 1811182017
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Entity Type | Organization
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Legal Business Name | JOHN W TAYLOR OD PC
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 59 BARRY ST
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City | HILLSDALE
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State | MI
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Zip | 49242-1809
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Country | US
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Telephone | 517-437-4300
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Fax |
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Provider Business Mailing Address
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Address Line | 59 BARRY ST
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City | HILLSDALE
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State | MI
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Zip | 49242-1809
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN W TAYLOR
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Credential |
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Telephone | 517-437-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002876
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License Number State | MI
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