MEDICARE: DR. ROBERT TAYLOR MD, FACS

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	208200000X	Plastic Surgery Physician	2086S0122X	AR

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	:	1447339544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT TAYLOR MD, FACS

Provider Business Mailing Address
First Line	:	3733 N BUSINESS DR
Second Line	:	SUITE 102
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-5203
Country	:	US
Telephone Number	:	479-521-1500
Fax Number	:	479-521-5413

Provider Business Practice Location Address
First Line	:	3733 N BUSINESS DR
Second Line	:	SUITE 102
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72703-5203
Country	:	US
Telephone Number	:	479-521-1500
Fax Number	:	479-521-5413

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	11/12/2015

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