Provider Demographics
NPI:1467478800
Name:TAYLOR, LAURA KATHLEEN (DO)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:KATHLEEN
Last Name:TAYLOR
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Gender:F
Credentials:DO
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Mailing Address - Street 1:5840 SOUTH MEMORIAL DRIVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:TULSON
Mailing Address - State:OK
Mailing Address - Zip Code:74145
Mailing Address - Country:US
Mailing Address - Phone:918-699-4250
Mailing Address - Fax:918-921-8824
Practice Address - Street 1:5840 SOUTH MEMORIAL DRIVE
Practice Address - Street 2:SUITE 302
Practice Address - City:TULSON
Practice Address - State:OK
Practice Address - Zip Code:74145
Practice Address - Country:US
Practice Address - Phone:918-699-4250
Practice Address - Fax:918-921-8824
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2024-07-10
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Provider Licenses
StateLicense IDTaxonomies
OK26542080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100038060EMedicaid
OK100038060EMedicaid
E74289Medicare UPIN