Taylor, Clark O
Taylor, Clark O is an individual health care provider with primary practice located at 805 S Reserve St , Missoula MT 59801-2104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as his primary health care specialty. Taylor, Clark O can be contacted via phone (406) 549-6600.Contact Information
Primary practice address
805 S Reserve St
Missoula MT 59801-2104
Phone: (406) 549-6600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 7822 | Montana |
Profile Details
| NPI number | 1689745804 |
|---|---|
| LBN Legal business name | Taylor, Clark O |
| Credentials | M.D.,D.D.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 10th, 2006 |
| Last updated | Mar 30th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689745804 | NPPES |
| Montana | MEDICAID | 1689745804 |
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