# FAMILY CARE SPEC, INC., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265501274
- **Authorized official:** DR. CHARLES JOSEPH CHOUTEAU MD (OWNER)
- **Authorized official phone:** (918) 786-6151

## Contact information

- **Practice address:** 601 E 13TH ST STE C, GROVE, OK 74344-2962
- **Practice address phone:** (918) 786-6151
- **Practice address fax:** (918) 786-3483
- **Mailing address:** 601 E 13TH ST STE C, GROVE, OK 74344-2962
- **Mailing address phone:** (918) 786-6151
- **Mailing address fax:** (918) 786-3483

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 12203 | OK | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 01/14/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 080029338 | RAILROAD MEDICARE | OK |
| 05 | — | 100738700A | — | OK |
| 01 | — | C08010 | RAILROAD MEDICARE | OK |