MEDICARE: DR. MARK C TAYLOR MD MPH

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	2083X0100X	Occupational Medicine Physician	33229	IA

General Provider Information

NPI Number	:	1629046784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK C TAYLOR MD MPH

Provider Business Mailing Address
First Line	:	830 1ST AVE NE
Second Line	:	ST LUKES CORPORATE HEALTH SERVICES
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52406-3026
Country	:	US
Telephone Number	:	319-369-8883
Fax Number	:	319-369-7012

Provider Business Practice Location Address
First Line	:	830 1ST AVE NE
Second Line	:	ST LUKES CORPORATE HEALTH SERVICES
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-3026
Country	:	US
Telephone Number	:	319-369-8153
Fax Number	:

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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