Organization
SALLISAW FAMILY MEDICINE, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK JOSEPH FUOCO (SOLE MEMBER)
(504) 495-6772
Entity
Organization
Contact information
Practice address
104 SOUTH OAK ST, SALLISAW, OK 74955
(918) 775-0063
Mailing address
5 TENNYSON PLACE, NEW ORLEANS, LA 70131
(504) 495-6772
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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