Provider Demographics
NPI:1780680686
Name:TAYLOR, LORNE FRANKLIN (DO)
Entity Type:Individual
Prefix:DR
First Name:LORNE
Middle Name:FRANKLIN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1739 E BEVERLY AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3593
Mailing Address - Country:US
Mailing Address - Phone:928-692-3456
Mailing Address - Fax:928-692-7071
Practice Address - Street 1:1739 E BEVERLY AVE
Practice Address - Street 2:STE 201
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86401-3593
Practice Address - Country:US
Practice Address - Phone:928-692-3456
Practice Address - Fax:928-692-7071
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ3907207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3907OtherLICENSE
AZ799653Medicaid
AZBT8125608OtherDEA
AZ799653Medicaid
AZBT8125608OtherDEA