Provider Demographics
NPI:1295166445
Name:TAYLOR, DANIEL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-3432
Mailing Address - Country:US
Mailing Address - Phone:888-426-9210
Mailing Address - Fax:888-426-9214
Practice Address - Street 1:408 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-3432
Practice Address - Country:US
Practice Address - Phone:888-426-9210
Practice Address - Fax:888-426-9214
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist