Provider Demographics
NPI:1548706559
Name:TAYLOR, ROY JR
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-2149
Mailing Address - Country:US
Mailing Address - Phone:419-902-4131
Mailing Address - Fax:
Practice Address - Street 1:5425 SOUTHWYCK BLVD
Practice Address - Street 2:STE 150
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1591
Practice Address - Country:US
Practice Address - Phone:419-902-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-13
Last Update Date:2023-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant