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Individual

JASON LAMAR TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1501 N WILLIAMSON AVE, WINSLOW, AZ 86047-2735
(928) 289-4691
Mailing address
2802 CIMARRON DR, KINGMAN, AZ 86401-7806
(928) 757-7510

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1364
NV
207P00000X
Emergency Medicine Physician
Primary
4184
AZ
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
1364
NV

Other

Enumeration date
09/28/2006
Last updated
08/14/2009
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