Provider Demographics
NPI:1134278443
Name:TAYLOR, WILLIAM JASON (R PH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JASON
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40977-1735
Mailing Address - Country:US
Mailing Address - Phone:606-337-1480
Mailing Address - Fax:606-337-1499
Practice Address - Street 1:308 S PINE ST
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40977-1735
Practice Address - Country:US
Practice Address - Phone:606-337-1480
Practice Address - Fax:606-337-1499
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist