# PRO-CARE FAMILY HEALTH OF OKLAHOMA , LLC

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

## Provider details

- **NPI number:** 1396234761
- **Authorized official:** CHRIS DOOLY (MEMBER)
- **Authorized official phone:** (918) 647-0670

## Contact information

- **Practice address:** 1103 DEWEY AVE, POTEAU, OK 74953-4411
- **Practice address phone:** (918) 647-0670
- **Practice address fax:** (918) 647-0460
- **Mailing address:** PO BOX 1278, POTEAU, OK 74953-1278
- **Mailing address phone:** (918) 647-0670
- **Mailing address fax:** (918) 647-0460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |
| 261QP1100X | Podiatric Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/01/2018
- **Last updated:** 08/09/2022