Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 8752 | MT |
NPI | 1174551337 |
---|---|
Provider Name | Mr. Richard Harlan Taylor |
First Address | Kalispell, MT 59901 |
Second Address | Kalispell, MT 59901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 02/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0068748 | (05) | MT |
D07572 | (02) | MT |