Provider Demographics
NPI:1982672143
Name:TAYLOR, DAVID RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:RICHARD
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 SIDNEY ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7203
Mailing Address - Country:US
Mailing Address - Phone:870-262-2000
Mailing Address - Fax:870-262-1062
Practice Address - Street 1:1215 SIDNEY ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7203
Practice Address - Country:US
Practice Address - Phone:870-262-2000
Practice Address - Fax:870-262-1062
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5242207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR11155701Medicaid
C67766Medicare UPIN
AR11155701Medicaid