Provider Demographics
NPI:1760521645
Name:LANCASTER, TAYLOR F (MD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:F
Last Name:LANCASTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 ALDERBROOK CT
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3029
Mailing Address - Country:US
Mailing Address - Phone:405-285-6901
Mailing Address - Fax:
Practice Address - Street 1:1705 RENAISSANCE BLVD
Practice Address - Street 2:STE 100
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3041
Practice Address - Country:US
Practice Address - Phone:405-285-6901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK235812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J8682OtherTEXAS BCBS
AR178784001Medicaid
AR771100501OtherARK BREASTCARE
OK200262360AMedicaid
TXN3130OtherTEXAS STATE LICENSE
AR1760521645OtherAR BCBS
TX204961101Medicaid
ARE6107OtherARK STATE LICENSE
AR5H8777044Medicare UPIN
TX204961101Medicaid