Provider Demographics
NPI:1114166139
Name:TAYLOR, WILLIAM RILEY (WILLIAM TAYLOR)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RILEY
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:WILLIAM TAYLOR
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1231
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-1231
Mailing Address - Country:US
Mailing Address - Phone:406-262-1305
Mailing Address - Fax:406-265-1651
Practice Address - Street 1:1660 SPRINGHILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1405
Practice Address - Country:US
Practice Address - Phone:251-665-8000
Practice Address - Fax:251-665-8010
Is Sole Proprietor?:No
Enumeration Date:2009-02-14
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8992207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C74212Medicare UPIN