Organization
MUSKOGEE FAMILY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S. SMITH A.R.N.P. (OWNER)
(918) 681-4646
Entity
Organization
Contact information
Practice address
1118 W BROADWAY ST, MUSKOGEE, OK 74401-6246
(918) 681-4646
(918) 684-9023
Mailing address
1118 W BROADWAY ST, MUSKOGEE, OK 74401-6246
(918) 681-4646
(918) 684-9023
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0035256
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200074640A
—
OK
Enumeration date
05/14/2007
Last updated
10/21/2009
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