Provider Demographics
NPI:1629752498
Name:TAYLOR, SETH EDWARD (PA-C)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:EDWARD
Last Name:TAYLOR
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:407 S MEDICAL ARTS CT STE E2
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3372
Mailing Address - Country:US
Mailing Address - Phone:307-257-2971
Mailing Address - Fax:
Practice Address - Street 1:407 S MEDICAL ARTS CT STE E2
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3372
Practice Address - Country:US
Practice Address - Phone:307-257-2971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2024-12-16
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant