Healthcare Provider Details

I. General information

NPI: 1376143669
Provider Name (Legal Business Name): TAYLOR AUSTIN FINCH BS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TAYLOR A FINCH BS

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 08/18/2021
Certification Date: 08/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 S HARVARD AVE
TULSA OK
74114-3300
US

IV. Provider business mailing address

4101 W PITTSBURG CIR
BROKEN ARROW OK
74012-6117
US

V. Phone/Fax

Practice location:
  • Phone: 918-712-4301
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: