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Individual

MARK JACKSON TAYLOR

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1112 WEST 6TH STREET, SUITE 104, LAWRENCE, KS 66044-2249
(785) 840-9700
(785) 840-9779
Mailing address
1112 WEST 6TH STREET, SUITE 104, LAWRENCE, KS 66044-2249
(785) 840-9700
(785) 840-9779

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
293
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
114014
BLUE CROSS
KS
01
26243029
BLUE CROSS METRO
KS
01
26243029
BLUE CROSS METRO
MO
Enumeration date
05/03/2006
Last updated
07/08/2007
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