Provider Demographics
NPI:1215903257
Name:TAYLOR, CHRIS W (MD)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:W
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 ROCK SPRINGS RD
Mailing Address - Street 2:P. O. BOX 2210
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-8933
Mailing Address - Country:US
Mailing Address - Phone:870-741-4124
Mailing Address - Fax:870-741-2211
Practice Address - Street 1:1425 ROCK SPRINGS RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-8933
Practice Address - Country:US
Practice Address - Phone:870-741-4124
Practice Address - Fax:870-741-2211
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2602207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR150397002Medicaid
AR7702499401OtherBREASTCARE PROVIDER NUMBE
AR160059273OtherRAILROAD MEDICARE
ARE2602OtherDR. MEDICAL LICENSE #
AR5L491OtherBLUE CROSS PROVIDER NUMBE
ARBT5558284OtherDEA NUMBER
AR5C917Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
AR5L491OtherBLUE CROSS PROVIDER NUMBE