Provider Demographics
NPI:1700444932
Name:DREISE, TAYLOR WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:WILLIAM
Last Name:DREISE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LINCOLN CIR SE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041-1836
Mailing Address - Country:US
Mailing Address - Phone:712-737-2000
Mailing Address - Fax:712-737-2115
Practice Address - Street 1:1000 LINCOLN CIR SE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1862
Practice Address - Country:US
Practice Address - Phone:712-737-2000
Practice Address - Fax:712-737-2115
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-11616207Q00000X
IADO-05707207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine