Provider Demographics
NPI:1528386752
Name:TAYLOR, JOHN ROLAND III (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ROLAND
Last Name:TAYLOR
Suffix:III
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 1:1710 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7303
Mailing Address - Country:US
Mailing Address - Phone:870-698-1846
Mailing Address - Fax:870-262-6571
Practice Address - Street 1:1710 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7303
Practice Address - Country:US
Practice Address - Phone:870-698-1846
Practice Address - Fax:870-262-6571
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-10529208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery