Individual
MR. JOHN SCOTT TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
407 14TH AVE SE, PUYALLUP, WA 98372-3770
(253) 697-1848
Mailing address
971 11TH LANE FI, FOX ISLAND, WA 98333-9643
(253) 238-0567
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301074254
MI
207P00000X
Emergency Medicine Physician
Primary
MD00048095
WA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
074254
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B51090
BLUE SHIELD
MI
05
—
104441890
—
MI
05
—
4786075
—
MI
Enumeration date
09/15/2006
Last updated
07/09/2008
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