Provider Demographics
NPI:1730116534
Name:TAYLOR, STEPHEN PETER (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PETER
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 N MONROE DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-6609
Mailing Address - Country:US
Mailing Address - Phone:937-372-4439
Mailing Address - Fax:937-372-4430
Practice Address - Street 1:1237 N MONROE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-6609
Practice Address - Country:US
Practice Address - Phone:937-372-4439
Practice Address - Fax:937-372-4430
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0433622Medicare UPIN