Provider Demographics
NPI:1073624342
Name:TAYLOR, SLOAN M (MD)
Entity Type:Individual
Prefix:MR
First Name:SLOAN
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5406 W 11000 N
Mailing Address - Street 2:SUITE 103-236
Mailing Address - City:HIGHLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84003-8942
Mailing Address - Country:US
Mailing Address - Phone:214-405-4300
Mailing Address - Fax:801-692-1457
Practice Address - Street 1:5406 W 11000 N
Practice Address - Street 2:SUITE 103-236
Practice Address - City:HIGHLAND
Practice Address - State:UT
Practice Address - Zip Code:84003-8942
Practice Address - Country:US
Practice Address - Phone:214-405-4300
Practice Address - Fax:801-692-1457
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2148207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0049NKOtherBCBS
0050NKOtherBCBS