Provider Demographics
NPI:1770751232
Name:ARTHUR M. TAYLOR, D.O., P.C.
Entity type:Organization
Organization Name:ARTHUR M. TAYLOR, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:480-285-1721
Mailing Address - Street 1:PO BOX 93246
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85070-3246
Mailing Address - Country:US
Mailing Address - Phone:480-285-1721
Mailing Address - Fax:480-285-1724
Practice Address - Street 1:4809 E THISTLE LANDING DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6498
Practice Address - Country:US
Practice Address - Phone:480-285-1721
Practice Address - Fax:480-285-1724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7179111N00000X
AZ7132111N00000X
AZ1030111N00000X
AZ0638213E00000X
AZ2750207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ70163OtherPACIFIC CARE
AZAZ0225510OtherBC/BS
AZIZ3316OtherHEALTHNET
AZ1111001OtherCIGNA
AZ131516OtherAHCCCS
AZAZ0225510OtherBC/BS
AZIZ3316OtherHEALTHNET