Provider Demographics
NPI:1720437262
Name:NEUMANN, TAYLOR (OD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:NEUMANN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 S 35TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-2063
Mailing Address - Country:US
Mailing Address - Phone:712-322-4554
Mailing Address - Fax:712-322-2340
Practice Address - Street 1:204 S 35TH ST STE 100
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-2063
Practice Address - Country:US
Practice Address - Phone:712-322-4554
Practice Address - Fax:712-322-2340
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA082762152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist