Provider Demographics
NPI:1902810872
Name:TAYLOR, BARBARA DIANE (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:DIANE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2860 ZEANDALE RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-9383
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1133 COLLEGE AVE
Practice Address - Street 2:SUITE C-143
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2770
Practice Address - Country:US
Practice Address - Phone:785-537-4940
Practice Address - Fax:785-537-0836
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2016-03-01
Deactivation Date:2015-01-06
Deactivation Code:
Reactivation Date:2016-03-01
Provider Licenses
StateLicense IDTaxonomies
KS0416737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100278750AMedicaid
KS016191Medicare ID - Type Unspecified
KS100278750AMedicaid