Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 52009 | OH |
NPI | 1073696837 |
---|---|
Provider Name | Dr. John Victor Taylor |
First Address | Euclid, OH 44132 |
Second Address | Euclid, OH 44132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 20/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A16213 | (02) |