Provider Demographics
NPI:1164431672
Name:TAYLOR, CAROL S (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:S
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4230 E PONTATOC CANYON DR
Mailing Address - Street 2:SUITE 207
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5233
Mailing Address - Country:US
Mailing Address - Phone:520-297-8518
Mailing Address - Fax:
Practice Address - Street 1:77 W FOREST AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-1479
Practice Address - Country:US
Practice Address - Phone:928-773-2505
Practice Address - Fax:928-773-2504
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-08-04
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Provider Licenses
StateLicense IDTaxonomies
AZ23743207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ349870Medicaid
AZ349870Medicaid
AZG31455Medicare UPIN