MEDICARE: DR. MICHAEL KIM TAYLOR D.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
1	111NI0900X	Internist Chiropractor	2087	OK

General Provider Information

NPI Number	:	1629297544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL KIM TAYLOR D.C.

Provider Business Mailing Address
First Line	:	3808 E 51ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-3657
Country	:	US
Telephone Number	:	918-749-3797
Fax Number	:	918-749-1536

Provider Business Practice Location Address
First Line	:	3808 E 51ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-3657
Country	:	US
Telephone Number	:	918-749-3797
Fax Number	:	918-749-1536

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	07/09/2007

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