# FAMILY MED LLC

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

## Provider details

- **NPI number:** 1396959482
- **Authorized official:** DR. JAY L GREGSTON MD (PHYSICIAN)
- **Authorized official phone:** (580) 252-0500

## Contact information

- **Practice address:** 2004 N HIGHWAY 81, DUNCAN, OK 73533-1460
- **Practice address phone:** (580) 252-0500
- **Practice address fax:** (580) 252-1020
- **Mailing address:** 2004 N HIGHWAY 81, DUNCAN, OK 73533-1460
- **Mailing address phone:** (580) 252-0500
- **Mailing address fax:** (580) 252-1020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/09/2007
- **Last updated:** 01/17/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100118660F | — | OK |
| 05 | — | 100254370B | — | OK |
| 05 | — | 200116880B | — | OK |
| 05 | — | 20116880A | — | OK |
| 01 | — | 586187246001 | BCBS PIN | OK |