Provider Demographics
NPI:1336039791
Name:SPEARS, TAYLOR JAMES
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JAMES
Last Name:SPEARS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TAYYLOR
Other - Middle Name:
Other - Last Name:SPEARS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:25 PRIVATE DRIVE 1211
Mailing Address - Street 2:
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669-8196
Mailing Address - Country:US
Mailing Address - Phone:740-716-1118
Mailing Address - Fax:
Practice Address - Street 1:25 PRIVATE DRIVE 1211
Practice Address - Street 2:
Practice Address - City:PROCTORVILLE
Practice Address - State:OH
Practice Address - Zip Code:45669-8196
Practice Address - Country:US
Practice Address - Phone:740-716-1118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 343900000X
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)