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General NPI Number Information
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NPI Number | 1134314388
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Entity Type | Organization
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Legal Business Name | FIRSTCARE MEDICAL CLINIC OF MUSKOGEE PLLC
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 3300 CHANDLER RD SUITE 105
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City | MUSKOGEE
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State | OK
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Zip | 74403-4957
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Country | US
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Telephone | 918-681-3333
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Fax | 918-681-3336
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Provider Business Mailing Address
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Address Line | 3300 CHANDLER RD SUITE 105
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City | MUSKOGEE
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State | OK
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Zip | 74403-4957
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Country | US
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Telephone | 918-681-3333
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Fax | 918-681-3336
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY D. ROBISON
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Credential | M.D.
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Telephone | 918-683-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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