Provider Demographics
NPI:1720067655
Name:TAYLOR, MARK P (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:P
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1230 E MAIN ST
Mailing Address - Street 2:PO BOX 8674
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-5066
Mailing Address - Country:US
Mailing Address - Phone:507-625-1811
Mailing Address - Fax:
Practice Address - Street 1:1230 E MAIN ST
Practice Address - Street 2:MANKATO CLINIC @ MAIN STREET
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5066
Practice Address - Country:US
Practice Address - Phone:507-625-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN28590207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
410849339 56001 C028OtherCHAMPUS
MN337385100Medicaid
160025572OtherRR MEDICARE
1652118OtherAMERICAS PPO MN
115554OtherUCARE MN
IA928549Medicaid
HP25870OtherHEALTH PARTNERS MN
0702740OtherMEDICA MN
NA2951023863OtherPREFERRED ONE MN
49433TAOtherBCBS MN
49433TAOtherBCBS MN
IA928549Medicaid