Provider Demographics
NPI:1346641917
Name:TAYLOR, CURTIS DEE IV
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:DEE
Last Name:TAYLOR
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 S CHAMBERS RD
Mailing Address - Street 2:S207
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-3561
Mailing Address - Country:US
Mailing Address - Phone:720-201-7574
Mailing Address - Fax:
Practice Address - Street 1:4141 E DICKENSON PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6012
Practice Address - Country:US
Practice Address - Phone:303-504-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO992590818172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO000000OtherGREAT-WEST HEALTHCARE/CIGNA