Provider Demographics
NPI:1942260286
Name:TAYLOR, MICHAEL R (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
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 1:2250 POSTAL DR
Mailing Address - Street 2:STE 4
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-4798
Mailing Address - Country:US
Mailing Address - Phone:775-727-8900
Mailing Address - Fax:775-727-9452
Practice Address - Street 1:2250 POSTAL DR
Practice Address - Street 2:STE 4
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-4798
Practice Address - Country:US
Practice Address - Phone:775-727-8900
Practice Address - Fax:775-727-9452
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01219111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTU48718Medicare UPIN