Provider Demographics
NPI:1407116403
Name:TAYLOR, JOHN JR (RRT, RCP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:RRT, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6803 MANSFIELD CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-9710
Mailing Address - Country:US
Mailing Address - Phone:910-354-4448
Mailing Address - Fax:910-339-4217
Practice Address - Street 1:108 HAY ST STE 305
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-5684
Practice Address - Country:US
Practice Address - Phone:910-354-4448
Practice Address - Fax:910-339-4217
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2279G0305X, 2279H0200X, 2279P3900X, 2279S1500X
NCA - 32682279P3900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health
No2279G0305XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeriatric Care
No2279P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredNeonatal/Pediatrics
No2279S1500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredSNF/Subacute Care