Provider Demographics
NPI:1124053178
Name:TAYLOR, CHRISTOPHER A (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:A
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1223 SWAN DR
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-5037
Mailing Address - Country:US
Mailing Address - Phone:918-336-8500
Mailing Address - Fax:918-336-8519
Practice Address - Street 1:1223 SWAN DR
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-5037
Practice Address - Country:US
Practice Address - Phone:918-336-8500
Practice Address - Fax:918-336-8519
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2653207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100252250BMedicaid
OKF40138Medicare UPIN