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NPI Code Detail

MEDICARE: HARRY B. TAYLOR PA-C

MEDICARE: HARRY B. TAYLOR PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA229OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11447256193OTHERNPI

General Provider Information

NPI Number : 1447256193
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARRY B. TAYLOR PA-C
Provider Business Mailing Address
First Line : 320 N SERVICE RD
Second Line :
City : MOORE
State : OK
Zip : 73160-4945
Country : US
Telephone Number : 405-794-4474
Fax Number : 405-793-8703
Provider Business Practice Location Address
First Line : 320 N SERVICE RD
Second Line :
City : MOORE
State : OK
Zip : 73160-4945
Country : US
Telephone Number : 405-794-4474
Fax Number : 405-793-8703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 04/01/2013

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