Taylor, Derek J.

Taylor, Derek J. is an individual health care provider with primary practice located at 4320 E. Presidio Street #101 , Mesa AZ 85215-3031. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Taylor, Derek J. can be contacted via phone (480) 706-9430.

Contact Information

Primary practice address
4320 E. Presidio Street #101 Mesa AZ 85215-3031
Phone: (480) 706-9430
Fax: (480) 378-2273
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X Arizona
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5941 Arizona

Profile Details

NPI number 1093111304
LBN Legal business name Taylor, Derek J.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2014
Last updated Apr 19th, 2018 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093111304 NPPES
Arizona MEDICAID 983703

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