Provider Demographics
NPI:1932113743
Name:TAYLOR, GREGORY S (MD)
Entity Type:Individual
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First Name:GREGORY
Middle Name:S
Last Name:TAYLOR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1490 E FOREMASTER DR
Mailing Address - Street 2:300
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-4488
Mailing Address - Country:US
Mailing Address - Phone:435-688-2104
Mailing Address - Fax:435-628-5308
Practice Address - Street 1:1490 E FOREMASTER DR
Practice Address - Street 2:300
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-4488
Practice Address - Country:US
Practice Address - Phone:435-688-2104
Practice Address - Fax:435-628-5308
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-11-29
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Provider Licenses
StateLicense IDTaxonomies
UT6240562-1205208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTI66001Medicare UPIN