Individual
DR. BRANDON MARK TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4740 N PENNGROVE WAY STE 210, MERIDIAN, ID 83646-7447
(208) 514-0203
Mailing address
4740 N PENNGROVE WAY STE 210, MERIDIAN, ID 83646-7447
(208) 514-0203
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
O0725
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36331415914
—
NE
05
—
833642513
—
ID
Enumeration date
05/01/2007
Last updated
01/29/2026
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