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NPI 1841636115

IndividualActive

Ethan Taylor

NPI 1841636115 · Case Manager/Care Coordinator · Tishomingo, OK

Provider details

NPI number: 1841636115
Entity type: Individual
Primary specialty: Case Manager/Care CoordinatorOther Service Providers
Sex: Male
Sole proprietor: Yes

Specialties & taxonomies

Case Manager/Care CoordinatorPrimary171M00000X
Other Service Providers

Practice location

1350 S Muldrow St

Tishomingo, OK 73460-3278

Phone: (830) 928-6990

Approximate (ZIP-level) locationGet directions

More OK providers

Mailing address

1350 S Muldrow St

Tishomingo, OK 73460-3278

Registry dates

Enumerated: 2013-05-14
Last updated: 2013-05-14

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Ethan Taylor — NPI 1841636115, Tishomingo, OK | NPI Central