Provider Demographics
NPI:1700516861
Name:HALEY, TAYLOR JAMES (OD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:JAMES
Last Name:HALEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:721 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-2503
Mailing Address - Country:US
Mailing Address - Phone:160-534-8740
Mailing Address - Fax:605-348-9773
Practice Address - Street 1:721 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-2503
Practice Address - Country:US
Practice Address - Phone:605-348-7401
Practice Address - Fax:605-348-9773
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD778152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist