Provider Demographics
NPI:1912951898
Name:TAGGART, JAMES ROSS (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROSS
Last Name:TAGGART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 EAST ST STE 210
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1153
Mailing Address - Country:US
Mailing Address - Phone:530-215-3820
Mailing Address - Fax:530-215-3745
Practice Address - Street 1:1555 EAST ST STE 210
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1153
Practice Address - Country:US
Practice Address - Phone:530-215-3820
Practice Address - Fax:530-215-3745
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82893207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ111241Medicaid
AZH10312Medicare UPIN
AZZ109987Medicare PIN
CAGS4152Medicare PIN