Provider Demographics
NPI:1750418240
Name:TAYLOR, JASON CURTIS (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:CURTIS
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 1:690 E WARNER RD
Mailing Address - Street 2:STE #113
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3054
Mailing Address - Country:US
Mailing Address - Phone:480-633-3399
Mailing Address - Fax:480-633-5605
Practice Address - Street 1:690 E WARNER RD
Practice Address - Street 2:SUITE 113
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3054
Practice Address - Country:US
Practice Address - Phone:480-633-3399
Practice Address - Fax:480-633-5605
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZV03703Medicare UPIN
AZ101162Medicare ID - Type Unspecified