Provider Demographics
NPI:1225087380
Name:TAYLOR, JAMES JOHN (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:JOHN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 W 32ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-3503
Mailing Address - Country:US
Mailing Address - Phone:417-347-5001
Mailing Address - Fax:417-347-2477
Practice Address - Street 1:1102 W 32ND ST STE 200
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3503
Practice Address - Country:US
Practice Address - Phone:417-347-5001
Practice Address - Fax:417-347-2477
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120188462086S0129X, 208600000X
VA0102204860208G00000X
MO2025024523208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200879910AMedicaid
VA1225087380Medicaid
TX045728502Medicaid
MO1225087380Medicaid
TXA8P8920OtherBLUE CROSS
NV1225087380Medicaid
MO1225087380Medicaid
KS200879910AMedicaid
TXA8P8920OtherBLUE CROSS