Provider Demographics
NPI:1902499916
Name:TAYLOR, WILLIAM O II
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:O
Last Name:TAYLOR
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:MAUD
Mailing Address - State:OK
Mailing Address - Zip Code:74854-0008
Mailing Address - Country:US
Mailing Address - Phone:405-301-2654
Mailing Address - Fax:
Practice Address - Street 1:32018 HWY 59
Practice Address - Street 2:
Practice Address - City:MAUD
Practice Address - State:OK
Practice Address - Zip Code:74854-7485
Practice Address - Country:US
Practice Address - Phone:405-374-1225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility