Provider Demographics
NPI:1770839854
Name:TAYLOR, ANTHONY J (OD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2111
Mailing Address - Country:US
Mailing Address - Phone:785-628-1114
Mailing Address - Fax:785-625-9167
Practice Address - Street 1:1517 E 27TH ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2111
Practice Address - Country:US
Practice Address - Phone:785-342-2882
Practice Address - Fax:785-625-9167
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1929152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist