Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35.120100 | OH |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 45809 | KY |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 48194 | CO |
NPI | 1134392269 |
---|---|
Provider Name | Dr. Michal Lee Taylor |
First Address | Brush, CO 80723 |
Second Address | Brush, CO 80723-1640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2008 |
Last Update Date | 17/03/2018 |