Provider Demographics
NPI:1740448620
Name:TAYLOR, JASON MAX (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:MAX
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:119 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-1302
Mailing Address - Country:US
Mailing Address - Phone:405-515-6246
Mailing Address - Fax:405-515-6249
Practice Address - Street 1:119 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1302
Practice Address - Country:US
Practice Address - Phone:405-515-6246
Practice Address - Fax:405-515-6249
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4693207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine