Provider Demographics
NPI:1649386855
Name:TAYLOR, THOMAS H (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:H
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N MAIN ST
Mailing Address - Street 2:WHITE RIVER JCT VA HOSPITAL
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05009-0001
Mailing Address - Country:US
Mailing Address - Phone:802-295-9363
Mailing Address - Fax:802-291-6257
Practice Address - Street 1:215 N MAIN ST
Practice Address - Street 2:WHITE RIVER JCT VA HOSPITAL
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05009-0001
Practice Address - Country:US
Practice Address - Phone:802-295-9363
Practice Address - Fax:802-291-6257
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6123207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1000696Medicaid
NHE98042Medicare UPIN
NHNH9914Medicare ID - Type Unspecified