Provider Demographics
NPI:1013116920
Name:TAYLOR, JEFFREY SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
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 1:1744 E MCANDREWS RD
Mailing Address - Street 2:STE. A
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5576
Mailing Address - Country:US
Mailing Address - Phone:541-779-8338
Mailing Address - Fax:541-779-8338
Practice Address - Street 1:1744 E MCANDREWS RD
Practice Address - Street 2:STE. A
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-5576
Practice Address - Country:US
Practice Address - Phone:541-779-8338
Practice Address - Fax:541-779-8338
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR71 3745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1013116920Medicaid
OR1013116920Medicare PIN
OR1013116920Medicare NSC
OR1013116920Medicare UPIN
OR1013116920Medicare Oscar/Certification