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NPI Code Detail

MEDICARE: TAYLER LEEF PA-C

MEDICARE: TAYLER LEEF 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
1363A00000XPhysician Assistant5467OK

General Provider Information

NPI Number : 1962212977
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLER LEEF PA-C
Provider Business Mailing Address
First Line : 5903 E 100TH PL
Second Line :
City : TULSA
State : OK
Zip : 74137-5508
Country : US
Telephone Number : 918-716-0205
Fax Number :
Provider Business Practice Location Address
First Line : 10109 E 79TH ST
Second Line :
City : TULSA
State : OK
Zip : 74133-4564
Country : US
Telephone Number : 918-233-9550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2025
Last Update Date : 03/02/2026

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Directions to “ TAYLER LEEF PA-C” Practice Location

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