Individual
TAYLOR M LEWALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3731 LEGACY, WEATHERFORD, OK 73096-9746
(580) 772-6777
Mailing address
921 FREEMONT PL, WEATHERFORD, OK 73096-2395
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4878
OK
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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