Provider Demographics
NPI:1407134588
Name:TAYLOR, ANDREW J
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:TAYLOR
Suffix:
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 1:135 S 300 W
Mailing Address - Street 2:APT 13
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-3281
Mailing Address - Country:US
Mailing Address - Phone:435-650-6945
Mailing Address - Fax:
Practice Address - Street 1:54 N 200 E
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2615
Practice Address - Country:US
Practice Address - Phone:435-867-2515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-24
Last Update Date:2011-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other