Provider Demographics
NPI:1053740696
Name:BARGER, TAYLOR (PA-C)
Entity type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:
Last Name:BARGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:RAMSAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:621 S MAIN ST
Mailing Address - Street 2:SUITE 1K
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1413
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 PLAZA DR
Practice Address - Street 2:
Practice Address - City:MONTOURSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17754-2448
Practice Address - Country:US
Practice Address - Phone:570-368-2235
Practice Address - Fax:570-368-3932
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056601363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant