| John D Taylor Md Pa | |
|
1018 Ohio St Pittsburg KS 66762-6437 | |
| (620) 231-5900 | |
| (620) 308-6901 |
| Full Name | John D Taylor Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1018 Ohio St, Pittsburg, Kansas |
| Authorized Official Name and Position | John D Taylor (PHYSICIAN/OWNER) |
| Authorized Official Contact | 6202315900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John D Taylor Md Pa 1018 Ohio St Pittsburg KS 66762-6437 Ph: (620) 231-5900 | John D Taylor Md Pa 1018 Ohio St Pittsburg KS 66762-6437 Ph: (620) 231-5900 |
| NPI Number | 1376638619 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 07/31/2012 |
| Medicare PECOS PAC ID | 1254306194 |
|---|---|
| Medicare Enrollment ID | O20040901001447 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376638619 | NPI | - | NPPES |
| 200264430A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 0430626 (Kansas) | Primary |
| Provider Name | John David Taylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457446791 PECOS PAC ID: 6406821347 Enrollment ID: I20040901001477 |
| Provider Name | Allyson R Grimaldi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912422106 PECOS PAC ID: 3375818289 Enrollment ID: I20171003005669 |
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