Provider Demographics
NPI:1952920613
Name:BILLINGS, TAYLOR GRANT (DO)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:GRANT
Last Name:BILLINGS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 N LITCHFIELD RD STE 110
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-1214
Mailing Address - Country:US
Mailing Address - Phone:623-935-9494
Mailing Address - Fax:623-935-9292
Practice Address - Street 1:1325 N LITCHFIELD RD STE 110
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-1214
Practice Address - Country:US
Practice Address - Phone:623-935-9494
Practice Address - Fax:623-935-9292
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY05317207R00000X
AZ010414208M00000X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty