Provider Demographics
NPI:1023381340
Name:TAYLOR, SCOTT ALEXANDER (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALEXANDER
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 S ELLSWORTH RD
Mailing Address - Street 2:102
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-2164
Mailing Address - Country:US
Mailing Address - Phone:480-354-2008
Mailing Address - Fax:480-907-1322
Practice Address - Street 1:2919 S ELLSWORTH RD
Practice Address - Street 2:102
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-2164
Practice Address - Country:US
Practice Address - Phone:480-299-5916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8239111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor