MEDICARE: DR. TODD BRIAN TAYLOR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	17839	AZ
2	207P00000X	Emergency Medicine Physician	4301050169	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255334785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD BRIAN TAYLOR M.D.

Provider Business Mailing Address
First Line	:	1323 E EL PARQUE DR
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-2649
Country	:	US
Telephone Number	:	480-731-4665
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 E MCDOWELL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-2612
Country	:	US
Telephone Number	:	602-239-6968
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	07/09/2007

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