Provider Demographics
NPI:1982608857
Name:TAYLOR, CATHY M (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
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:PO BOX 943
Mailing Address - Street 2:
Mailing Address - City:CHANUTE
Mailing Address - State:KS
Mailing Address - Zip Code:66720-0943
Mailing Address - Country:US
Mailing Address - Phone:620-431-0340
Mailing Address - Fax:620-431-0434
Practice Address - Street 1:1409 W 7TH ST
Practice Address - Street 2:
Practice Address - City:CHANUTE
Practice Address - State:KS
Practice Address - Zip Code:66720-0943
Practice Address - Country:US
Practice Address - Phone:620-431-0340
Practice Address - Fax:620-431-0434
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0420988207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0823810001OtherDMERC
KS100206150CMedicaid
KS160045926OtherRR MEDICARE PTAN
KS160045926OtherRR MEDICARE PTAN
KS054578Medicare PIN