| My Doctor Family Care, Llc | |
| 
					10106 S Sheridan Rd Ste B Tulsa OK 74133-6776  | |
| (918) 619-9400 | |
| (918) 600-2980 | 
| Full Name | My Doctor Family Care, Llc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 10106 S Sheridan Rd Ste B, Tulsa, Oklahoma | 
| Authorized Official Name and Position | Stanley R Stacy (PHYSICIAN/MEMBER) | 
| Authorized Official Contact | 9186199400 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| My Doctor Family Care, Llc 10106 S Sheridan Rd Ste B Tulsa OK 74133-6776 Ph: (918) 619-9400  | My Doctor Family Care, Llc 10106 S Sheridan Rd Ste B Tulsa OK 74133-6776 Ph: (918) 619-9400  | 
| NPI Number | 1316629868 | 
|---|---|
| Provider Enumeration Date | 08/03/2023 | 
| Last Update Date | 08/30/2023 | 
| Medicare PECOS PAC ID | 6800241233 | 
|---|---|
| Medicare Enrollment ID | O20231004003723 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1316629868 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
| Provider Name | Stanley Stacy | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1225018757 PECOS PAC ID: 7416861620 Enrollment ID: I20090729000243  | 
| Provider Name | Tara B Hasenpflug | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1033400544 PECOS PAC ID: 9537391065 Enrollment ID: I20140826001314  | 
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