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Individual

MARK P TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1230 E MAIN ST, MANKATO CLINIC @ MAIN STREET, MANKATO, MN 56001-5066
(507) 625-1811
Mailing address
1230 E MAIN ST, PO BOX 8674, MANKATO, MN 56001-5066
(507) 625-1811

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
28590
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0702740
MEDICA MN
01
115554
UCARE MN
01
160025572
RR MEDICARE
01
1652118
AMERICAS PPO MN
05
337385100
MN
01
410849339 56001 C028
CHAMPUS
01
49433TA
BCBS MN
05
928549
IA
01
HP25870
HEALTH PARTNERS MN
01
NA2951023863
PREFERRED ONE MN
Enumeration date
01/10/2006
Last updated
07/15/2020
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