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Individual

BRUCE T TAYLOR

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1034 NORTH 500 WEST, PROVO, UT 84604
(801) 373-7850
Mailing address
PO BOX 26974, SALT LAKE CITY, UT 84126
(800) 789-7342
(616) 975-9827

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
1554761205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04753
UT
Enumeration date
06/07/2006
Last updated
07/08/2007
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