Provider Demographics
NPI:1053347872
Name:TAYLOR, WIILLIAM MARCUS (PT)
Entity type:Individual
Prefix:
First Name:WIILLIAM MARCUS
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:W. MARCUS
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3461 WARRENSVILLLE CENTER ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHAKER
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4100
Mailing Address - Country:US
Mailing Address - Phone:216-233-3412
Mailing Address - Fax:
Practice Address - Street 1:3461 WARRENSVILLE CENTER RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44122-5260
Practice Address - Country:US
Practice Address - Phone:216-233-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH95372251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2452171Medicaid
OH2452171Medicaid