Provider Demographics
NPI:1982150231
Name:TAYLUM MEDICAL LLC
Entity Type:Organization
Organization Name:TAYLUM MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ALISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-231-6139
Mailing Address - Street 1:3144 S WINSTON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2012
Mailing Address - Country:US
Mailing Address - Phone:918-794-4481
Mailing Address - Fax:
Practice Address - Street 1:3144 S WINSTON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2012
Practice Address - Country:US
Practice Address - Phone:918-794-4481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory