Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 04-39336 | KS |
N | 208800000X | Urologist | 041202 | CT |
N | 208800000X | Urologist | 2017013714 | MO |
NPI | 1003813940 |
---|---|
Provider Name | John A Taylor III |
First Address | Kansas City, KS 66160-0001 |
Second Address | Kansas City, KS 66160-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1412022 | (05) | CT |
H81293 | (02) | CT |