Provider Demographics
NPI:1629752498
Name:TAYLOR, SETH EDWARD
Entity Type:Individual
Prefix:MR
First Name:SETH
Middle Name:EDWARD
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 1:379 SMITH DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-8677
Mailing Address - Country:US
Mailing Address - Phone:740-350-8289
Mailing Address - Fax:
Practice Address - Street 1:379 SMITH DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-8677
Practice Address - Country:US
Practice Address - Phone:740-350-8289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant