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NPI Code Detail

MEDICARE: CHRISTOPHER AQUIES TAYLOR PA-C

MEDICARE: CHRISTOPHER AQUIES 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
1363A00000XPhysician Assistant1102190TX

General Provider Information

NPI Number : 1205108222
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER AQUIES TAYLOR PA-C
Provider Business Mailing Address
First Line : 4301 WILSON ST
Second Line :
City : LAWTON
State : OK
Zip : 73503-4472
Country : US
Telephone Number : 580-558-3612
Fax Number :
Provider Business Practice Location Address
First Line : 4301 WILSON ST
Second Line :
City : LAWTON
State : OK
Zip : 73503-4472
Country : US
Telephone Number : 580-558-3612
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2012
Last Update Date : 03/19/2013

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Directions to “ CHRISTOPHER AQUIES TAYLOR PA-C” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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