MEDICARE: JOHN TAYLOR JR. RRT, RCP

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	2279G0305X	Geriatric Care Registered Respiratory Therapist
2	2279H0200X	Home Health Registered Respiratory Therapist
3	2279P3900X	Neonatal/Pediatric Registered Respiratory Therapist
4	2279P3900X	Neonatal/Pediatric Registered Respiratory Therapist	A - 3268	NC
5	2279S1500X	SNF/Subacute Care Registered Respiratory Therapist

General Provider Information

NPI Number	:	1407116403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN TAYLOR JR. RRT, RCP

Provider Business Mailing Address
First Line	:	6803 MANSFIELD CT
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-9710
Country	:	US
Telephone Number	:	910-354-4448
Fax Number	:	910-339-4217

Provider Business Practice Location Address
First Line	:	108 HAY ST STE 305
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28301-5684
Country	:	US
Telephone Number	:	910-354-4448
Fax Number	:	910-339-4217

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

Provider Enumeration Date	:	05/23/2012
Last Update Date	:	05/23/2012

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