Basic Information
| Provider Information | |||||||||
| NPI: | 1144264268 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | K. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 90 JACKSON PIKE | ||||||||
| Address2: | |||||||||
| City: | GALLIPOLIS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456311560 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404465890 | ||||||||
| FaxNumber: | 7404465982 | ||||||||
| Practice Location | |||||||||
| Address1: | 88 E MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | POMEROY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457699569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7409920060 | ||||||||
| FaxNumber: | 7404465154 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 02/26/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 34-00-8282 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 2238 | WV | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000185268 | 01 | OH | UNISON MEDICAID | OTHER | 3810000767 | 05 | WV | MEDICAID | 310917085079 | 01 | OH MEDICAID CARESOURCE | OTHER | P00158638 | 01 | RR MEDICARE | OTHER | 000000343883 | 01 | ANTHEM BCBS | OTHER | 001714162 | 01 | MOUNTAIN STATE BCBS | OTHER | 2509744 | 01 | OH | MOLINA MEDICAID | OTHER |