Blake Taylor, D.O.
Family Medicine in Provo, UT. Individual provider (NPI-1).
NPI number1114458262
StatusActive
Last updated in NPPESFeb 25, 2019
Details
- NPI
- 1114458262
- Entity type
- Individual (NPI-1)
- Name
- Blake Taylor
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 21, 2017
- Last updated
- Feb 25, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - FAMILY PRACTICE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 10939818-1204 | UT | Yes |
Practice location
475 W 940 NProvo, UT 84604-3301
Phone 801-357-7926
Mailing address
Po Box 27128Salt Lake City, UT 84127-0128
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 128 Family Medicine Physician providers in Provo · All 6,098 providers in Provo
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