Provider Demographics
NPI:1821438417
Name:TAYLOR, REBECCA VIRGINIA (DO)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:VIRGINIA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:VIRGINIA
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1201 E 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4372
Mailing Address - Country:US
Mailing Address - Phone:907-561-4500
Mailing Address - Fax:907-561-4806
Practice Address - Street 1:1201 E 36TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4372
Practice Address - Country:US
Practice Address - Phone:907-561-4500
Practice Address - Fax:907-561-4806
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7840207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine