Provider Demographics
NPI:1073302865
Name:TAYLOR, ROBERT SCOTT (CPSS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:SCOTT
Last Name:TAYLOR
Suffix:
Gender:
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-4124
Mailing Address - Country:US
Mailing Address - Phone:801-600-7504
Mailing Address - Fax:
Practice Address - Street 1:350 E 400 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-2993
Practice Address - Country:US
Practice Address - Phone:801-600-7504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTF25-117170175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist