Provider Demographics
NPI:1104387513
Name:KING, TAYLOR (DO)
Entity type:Individual
Prefix:MISS
First Name:TAYLOR
Middle Name:
Last Name:KING
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3731 IRISH DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-6638
Mailing Address - Country:US
Mailing Address - Phone:319-206-7370
Mailing Address - Fax:319-206-7380
Practice Address - Street 1:3731 IRISH DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-6638
Practice Address - Country:US
Practice Address - Phone:319-206-7370
Practice Address - Fax:319-206-7380
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-06681208000000X
390200000X
MN73866208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program