Jack Bryan Taylor, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

17050 Issued in OK

Practice address

2029 Gordon Cooper Dr
Shawnee, OK 74801-9005

Phone

(405) 878-5859

Fax

(405) 214-4230

NPI assigned

Dec 2, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1962049635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748019005",
            "telephone_number": "405-878-5859",
            "fax_number": "405-214-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 GORDON COOPER DR",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748019005",
            "telephone_number": "405-878-5859",
            "fax_number": "405-214-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JACK",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "17050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ray Tainpeah
• Larry Sidney Tanner, RPT
• Regina Steciak Tanner, PT
• Trisha Louise Taron, APRN
• Ashlee Tasetano, MOTR/L
• Stacey Lynn Taylor, PT
• Taylor'D Educational Therapy Services, LLC
• Taylor'D Therapy Services, L.L.C.
• Team Clinics Ah LLC
• Team Clinics Ah LLC

• Pharmacist in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.