Provider Demographics
NPI:1831355957
Name:TAYLOR, BENEDICT JAMES WINSTON (MD)
Entity type:Individual
Prefix:DR
First Name:BENEDICT
Middle Name:JAMES WINSTON
Last Name:TAYLOR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3340 E GOLDSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-1026
Mailing Address - Country:US
Mailing Address - Phone:208-367-7787
Mailing Address - Fax:208-367-7789
Practice Address - Street 1:6140 W CURTISIAN
Practice Address - Street 2:STE 102
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-0109
Practice Address - Country:US
Practice Address - Phone:208-367-7787
Practice Address - Fax:208-367-7789
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2015-08-31
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Provider Licenses
StateLicense IDTaxonomies
CAA94309208G00000X
IDM-12959208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)