Provider Demographics
NPI:1518128297
Name:DRAKE, TAYLOR A (DO)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:A
Last Name:DRAKE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:A
Other - Last Name:COPPING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 DUFF AVENUE
Mailing Address - Street 2:MCFARLAND CLINIC, PC
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010
Mailing Address - Country:US
Mailing Address - Phone:515-239-4404
Mailing Address - Fax:515-239-4721
Practice Address - Street 1:1215 DUFF AVENUE
Practice Address - Street 2:MCFARLAND CLINIC, PC
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010
Practice Address - Country:US
Practice Address - Phone:515-239-4404
Practice Address - Fax:515-239-4721
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA04168208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500633195Medicaid
R160380Medicare PIN