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Organization

FAMILY CARE CLINIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK ROGOW MD (PHYSICIAN)
(918) 776-0050
Entity
Organization

Contact information

Practice address
1506 W CHICKASAW AVE, SALLISAW, OK 74955-7200
(918) 776-0050
(918) 776-0065
Mailing address
1506 W CHICKASAW AVE, SALLISAW, OK 74955-7200
(918) 776-0050
(918) 776-0065

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
27009
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200245750
OK
Enumeration date
06/08/2017
Last updated
07/21/2022
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