Organization
JOHN E TAYLOR O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E TAYLOR O.D. (OWNER)
(406) 278-5331
Entity
Organization
Contact information
Practice address
403 S DELAWARE ST, CONRAD, MT 59425-2310
(406) 278-5331
(406) 278-7379
Mailing address
403 S DELAWARE ST, CONRAD, MT 59425-2310
(406) 278-5331
(406) 278-7379
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
345
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SSN#
MT
05
—
048-9684
—
MT
01
—
1871661355
NPI TYPE 1
MT
Enumeration date
04/02/2007
Last updated
08/22/2020
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