Provider Demographics
NPI:1447368121
Name:TAYLOR, DARRIN (PA-C)
Entity type:Individual
Prefix:MR
First Name:DARRIN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13109 STERLING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-6644
Mailing Address - Country:US
Mailing Address - Phone:417-766-2043
Mailing Address - Fax:
Practice Address - Street 1:1312 E HWY MO-72
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-6540
Practice Address - Country:US
Practice Address - Phone:573-426-4112
Practice Address - Fax:573-312-3857
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000146377363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical