MEDICARE: JASON RODNEY 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	207R00000X	Internal Medicine Physician	4301088668	MI
2	207RG0100X	Gastroenterology Physician	2011012613	MO
3	390200000X	Student in an Organized Health Care Education/Training Program	4301088668	MI
4	207RG0100X	Gastroenterology Physician	4301088668	MI

General Provider Information

NPI Number	:	1972623536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON RODNEY TAYLOR M.D.

Provider Business Mailing Address
First Line	:	660 MASON RIDGE CENTER DR STE 300
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8512
Country	:	US
Telephone Number	:	314-448-3791
Fax Number	:	314-996-7658

Provider Business Practice Location Address
First Line	:	11155 DUNN RD STE 309E
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6111
Country	:	US
Telephone Number	:	314-953-8799
Fax Number	:	314-953-8798

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	09/19/2025

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