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Organization
FEDCARE, LLC
Active
Organization
FEDCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILI GRAGG (OPERATIONS MANAGER)
(405) 219-2651
Entity
Organization
Contact information
Practice address
1801 N BROADWAY AVE, OKLAHOMA CITY, OK 73103-3446
(405) 219-2651
(405) 429-5191
Mailing address
PO BOX 152, OKLAHOMA CITY, OK 73101-0152
(405) 219-2651
(405) 609-6679
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
NULL
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
NULL
208VP0014X
Interventional Pain Medicine Physician
—
—
209800000X
Legal Medicine (M.D./D.O.) Physician
—
NULL
209800000X
Legal Medicine (M.D./D.O.) Physician
—
—
Other
Enumeration date
09/17/2025
Last updated
09/17/2025
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