Provider Demographics
NPI:1083779458
Name:TAYLOR, WADE ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:WADE
Middle Name:ALAN
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 1:1810 PINION RD
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-4393
Mailing Address - Country:US
Mailing Address - Phone:775-753-7387
Mailing Address - Fax:775-738-4918
Practice Address - Street 1:1810 PINION RD
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-4393
Practice Address - Country:US
Practice Address - Phone:775-753-7387
Practice Address - Fax:775-738-4918
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-1008111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV38498Medicare PIN
NV38496Medicare PIN
NV38498Medicare UPIN