| Family Care Of Tulsa, Inc | |
|
4720 S Harvard Ave Ste 102 Tulsa OK 74135-3048 | |
| (918) 744-0194 | |
| (918) 744-4085 |
| Full Name | Family Care Of Tulsa, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4720 S Harvard Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Don R Roller (OWNER) |
| Authorized Official Contact | 9187440194 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Care Of Tulsa, Inc 4720 S Harvard Ave Ste 102 Tulsa OK 74135-3048 Ph: (918) 744-0194 | Family Care Of Tulsa, Inc 4720 S Harvard Ave Ste 102 Tulsa OK 74135-3048 Ph: (918) 744-0194 |
| NPI Number | 1902945439 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 07/09/2010 |
| Medicare PECOS PAC ID | 9133158884 |
|---|---|
| Medicare Enrollment ID | O20050811001153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902945439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01897 (Oklahoma) | Primary |
| Provider Name | Don R Roller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871577940 PECOS PAC ID: 1951330604 Enrollment ID: I20100916000567 |
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