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Organization
FAMILY MEDICINE SPECIALISTS, P.C.
Active
Organization
FAMILY MEDICINE SPECIALISTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY MICHELLE FERRELL (OFFICE MANAGER)
(405) 273-6383
Entity
Organization
Contact information
Practice address
3700 N KICKAPOO AVE, SUITE 124, SHAWNEE, OK 74804-1707
(405) 273-6383
(405) 214-1075
Mailing address
3700 N KICKAPOO AVE, SUITE 124, SHAWNEE, OK 74804-1707
(405) 273-6383
(405) 214-1075
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100745230C
—
OK
Enumeration date
08/30/2006
Last updated
07/26/2011
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