MEDICARE: J. DUSTIN TAYLOR D.C.

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	111N00000X	Chiropractor	1715	AR

General Provider Information

NPI Number	:	1881886893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	J. DUSTIN TAYLOR D.C.

Provider Business Mailing Address
First Line	:	1361 WHITE DR
Second Line	:
City	:	BATESVILLE
State	:	AR
Zip	:	72501-9467
Country	:	US
Telephone Number	:	870-698-1650
Fax Number	:

Provider Business Practice Location Address
First Line	:	1361 WHITE DR
Second Line	:
City	:	BATESVILLE
State	:	AR
Zip	:	72501-9467
Country	:	US
Telephone Number	:	870-698-1650
Fax Number	:

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

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	03/03/2015

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