Individual
MR. TRENT ALLEN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5000
Mailing address
5915 WYANDOTTE ST, KANSAS CITY, MO 64113
(615) 268-0914
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2004001486
MO
207P00000X
Emergency Medicine Physician
30533
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3095825
BLUE CROSS
TN
01
—
3126225
BLUE CROSS
TN
01
—
3136126
BLUE CROSS
TN
05
—
3829745
—
TN
05
—
3829746
—
TN
05
—
3829747
—
TN
Enumeration date
03/14/2006
Last updated
07/08/2007
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