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Organization
FAMILY CARE SPEC, INC., P.C.
Active
Organization
FAMILY CARE SPEC, INC., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JOSEPH CHOUTEAU MD (OWNER)
(918) 786-6151
Entity
Organization
Contact information
Practice address
601 E 13TH ST STE C, GROVE, OK 74344-2962
(918) 786-6151
(918) 786-3483
Mailing address
601 E 13TH ST STE C, GROVE, OK 74344-2962
(918) 786-6151
(918) 786-3483
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12203
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080029338
RAILROAD MEDICARE
OK
05
—
100738700A
—
OK
01
—
C08010
RAILROAD MEDICARE
OK
Enumeration date
11/06/2006
Last updated
01/14/2009
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