| Doctor Name: | THAD L TAYLOR |
| NPI Number: | 1023381357 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP |
| License Number: | 2012005450 |
| Business Practice Address: | 2817 Saint Johns Blvd Emergency Department Joplin, MO - 648041563 |
| Business Phone Number: | 4176252300 |
| Business Fax Number: | 4176252005 |
| Mailing Address: | 2817 Saint Johns Blvd, Emergency Department JOPLIN |
| State: | MO |
| Postal Code: | 648041563 |
| Phone Number: | 4176252300 |
| Fax Number: | 4176252005 |
| NPI Enumeration Date: | 02/16/2012 |
| NPI Last Update Date: | 02/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2012005450 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |