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General NPI Number Information
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NPI Number | 1578500195
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICAL CARE OF TULSA INC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7600 S LEWIS AVE
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City | TULSA
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State | OK
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Zip | 74136-6836
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Country | US
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Telephone | 918-493-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 7600 S LEWIS AVE
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City | TULSA
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State | OK
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Zip | 74136-6836
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Country | US
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Telephone | 918-493-7800
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE
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Name | CINDI KNEFF
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Credential |
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Telephone | 918-493-7800
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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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