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General NPI Number Information
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NPI Number | 1851351548
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Entity Type | Individual
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Provider Name | JAMES ALLAN TAYLOR D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/25/2006
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Last Update Date | 03/20/2021
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Provider Practice Location Address
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Address Line | 4219 MAYBECK DR. NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525
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Country | US
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Telephone | 616-724-4877
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Fax | 616-724-4641
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Provider Business Mailing Address
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Address Line | 1331 HORTON RD SUITE A
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City | JACKSON
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State | MI
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Zip | 49203-5260
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Country | US
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Telephone | 517-784-4242
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Fax | 517-784-6943
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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 | 5101009480
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License Number State | MI
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