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General NPI Number Information
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NPI Number | 1497279061
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Entity Type | Organization
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Legal Business Name | TAYLORS SURGICAL ASSISTING LLC
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8718 E 116TH ST N
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City | OWASSO
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State | OK
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Zip | 74055-6527
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Country | US
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Telephone | 918-557-2576
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Fax |
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Provider Business Mailing Address
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Address Line | 8718 E 116TH ST N
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City | OWASSO
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State | OK
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Zip | 74055-6527
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Country | US
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Telephone | 918-557-2576
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA M TAYLOR
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Credential |
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Telephone | 918-557-2576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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