Taylor, Derek Carr
Taylor, Derek Carr is an individual health care provider with primary practice located at 1130 Nw 22Nd Ave Suite 410, Portland OR 97210-2900. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Taylor, Derek Carr can be contacted via phone (503) 229-7137.Contact Information
Primary practice address
1130 Nw 22Nd Ave Suite 410
Portland OR 97210-2900
Phone: (503) 229-7137
Fax: (503) 241-0628
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MD23195 | Oregon |
Profile Details
| NPI number | 1487766911 |
|---|---|
| LBN Legal business name | Taylor, Derek Carr |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487766911 | NPPES |
| Oregon | MEDICAID | 286363 |
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