Provider Demographics
NPI:1720038086
Name:TAYLOR, ROY ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:ANDREW
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 1:3127 BRANDYWINE WAY
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-3878
Mailing Address - Country:US
Mailing Address - Phone:360-739-0948
Mailing Address - Fax:
Practice Address - Street 1:3127 BRANDYWINE WAY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-3878
Practice Address - Country:US
Practice Address - Phone:360-739-0948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000163022086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8464083Medicaid
WAG8859993Medicare PIN