Provider Demographics
NPI:1366132367
Name:TAYLOR, DAVID GRAYSON JR (PA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:GRAYSON
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:3 KEPH DR APT 2
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-3254
Mailing Address - Country:US
Mailing Address - Phone:716-939-6157
Mailing Address - Fax:
Practice Address - Street 1:2570 HAYMAKER RD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3513
Practice Address - Country:US
Practice Address - Phone:412-858-7618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-11-30
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant