Provider Demographics
NPI:1720597289
Name:TAYLOR, FRANK A JR (BHHN,MH,ND)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:A
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:BHHN,MH,ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2833 CLARKE ROAD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115
Mailing Address - Country:US
Mailing Address - Phone:901-458-3663
Mailing Address - Fax:
Practice Address - Street 1:6061 HICKORY RIDGE MALL STE. 452
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115
Practice Address - Country:US
Practice Address - Phone:901-383-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-27
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN47-2051439OtherTAXPAYER IDENTIFICATION NUMBER