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NPI Code Detail

MEDICARE: MR. ALAN WAYNE TAYLOR

MEDICARE: MR. ALAN WAYNE TAYLOR
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
1363AM0700XMedical Physician AssistantPA1157OK

General Provider Information

NPI Number : 1316932676
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALAN WAYNE TAYLOR
Provider Business Mailing Address
First Line : 2115 PARKVIEW DRIVE
Second Line :
City : EL RENO
State : OK
Zip : 73036-2109
Country : US
Telephone Number : 405-262-2640
Fax Number : 405-422-2521
Provider Business Practice Location Address
First Line : 2115 PARKVIEW DRIVE
Second Line :
City : EL RENO
State : OK
Zip : 73036-2109
Country : US
Telephone Number : 405-262-2640
Fax Number : 405-422-2521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2005
Last Update Date : 06/02/2015

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Directions to “ MR. ALAN WAYNE TAYLOR ” Practice Location

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