Provider Demographics
NPI:1306082565
Name:SIDNEY D. TAYLOR, D.C., P.C.
Entity type:Organization
Organization Name:SIDNEY D. TAYLOR, D.C., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-946-9946
Mailing Address - Street 1:3617 N. MERIDIAN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2823
Mailing Address - Country:US
Mailing Address - Phone:405-946-9946
Mailing Address - Fax:405-946-0757
Practice Address - Street 1:3617 N. MERIDIAN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-2823
Practice Address - Country:US
Practice Address - Phone:405-946-9946
Practice Address - Fax:405-946-0757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKB5316OtherGROUP PTAN
OKOKB5316OtherGROUP PTAN