Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 4306 | OK |
NPI | 1134699127 |
---|---|
Provider Name | Dr. Taylor Andrew Langebartels |
First Address | Tulsa, OK 74134-7215 |
Second Address | Tulsa, OK 74134-7215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2018 |
Last Update Date | 03/12/2018 |