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General NPI Number Information
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NPI Number | 1427245646
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Entity Type | Organization
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Legal Business Name | FAMILY CARE OF WOODWARD LLC
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 1611 MAIN ST SUITE 203
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City | WOODWARD
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State | OK
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Zip | 73801-3021
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Country | US
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Telephone | 580-256-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 MAIN ST SUITE 203
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City | WOODWARD
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State | OK
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Zip | 73801-3021
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Country | US
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Telephone | 580-256-2900
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER/OWNER
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Name | ROBIN SHEMANSKI
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Credential | RN
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Telephone | 580-256-2900
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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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