Individual
JERALD B TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
48 W 1500 N, NEPHI, UT 84648-8900
(435) 623-3200
(435) 623-3180
Mailing address
PO BOX 120, NEPHI, UT 84648-0120
(435) 623-3200
(435) 623-3180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
375388-1204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870419324004
—
UT
Enumeration date
07/17/2006
Last updated
10/19/2007
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