Individual
ELLIS R TAYLOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
232 S WOODS MILL RD, CHESTERFIELD, MO 63017
(314) 205-6917
Mailing address
940 W PORT PLAZA, STE 270, ST LOUIS, MO 63146
(314) 453-0600
(314) 453-0083
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
R1C18
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202212783
—
MO
Enumeration date
08/30/2006
Last updated
01/02/2013
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