Provider Demographics
NPI:1295026615
Name:TAYLOR, DAVID PAUL (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 BUTTERMILK LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH THOMASTON
Mailing Address - State:ME
Mailing Address - Zip Code:04858-3008
Mailing Address - Country:US
Mailing Address - Phone:207-594-5332
Mailing Address - Fax:
Practice Address - Street 1:35 ELM ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1910
Practice Address - Country:US
Practice Address - Phone:207-236-4546
Practice Address - Fax:207-236-3183
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3066183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist