| NPI | 1124531736 |
|---|---|
| Doing Business As | FAMILY PHYSICIAN |
| Entity Type | Organization |
| Authorized Contact | VALERIE M PACK Family Physician 918-728-4942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 5857) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2021-08-23 |