Individual
MR. PRINCE WILLIAM TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
5501 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2074
(405) 604-6000
Mailing address
3115 NW 21ST ST, OKLAHOMA CITY, OK 73107-3009
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1121
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096360A
—
OK
Enumeration date
05/18/2006
Last updated
04/20/2021
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