# FAMILY MEDICINE SPECIALISTS, P.C.

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

## Provider details

- **NPI number:** 1407966575
- **Authorized official:** TRACY MICHELLE FERRELL (OFFICE MANAGER)
- **Authorized official phone:** (405) 273-6383

## Contact information

- **Practice address:** 3700 N KICKAPOO AVE, SUITE 124, SHAWNEE, OK 74804-1707
- **Practice address phone:** (405) 273-6383
- **Practice address fax:** (405) 214-1075
- **Mailing address:** 3700 N KICKAPOO AVE, SUITE 124, SHAWNEE, OK 74804-1707
- **Mailing address phone:** (405) 273-6383
- **Mailing address fax:** (405) 214-1075

## Taxonomy

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

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 07/26/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100745230C | — | OK |