Individual
TAYLOR DIANE IAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1205 HEALTH CENTER PKWY STE 240, YUKON, OK 73099-6396
(405) 717-5496
(405) 717-5499
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(405) 717-5496
(405) 717-5499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2963
OK
Other
Enumeration date
12/17/2018
Last updated
10/16/2020
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