| Our Family Doctor Llc | |
|
12702 E 86th St N Owasso OK 74055-2548 | |
| (918) 274-9300 | |
| Not Available |
| Full Name | Our Family Doctor Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 12702 E 86th St N, Owasso, Oklahoma |
| Authorized Official Name and Position | Clinton R Childs (PHYSICIAN/OWNER) |
| Authorized Official Contact | 9185309999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Our Family Doctor Llc 12702 E 86th St N Owasso OK 74055-2548 Ph: (918) 274-9300 | Our Family Doctor Llc 12702 E 86th St N Owasso OK 74055-2548 Ph: (918) 274-9300 |
| NPI Number | 1992537211 |
|---|---|
| Provider Enumeration Date | 08/15/2024 |
| Last Update Date | 08/15/2024 |
| Medicare PECOS PAC ID | 6800325242 |
|---|---|
| Medicare Enrollment ID | O20250129002883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992537211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Clinton R Childs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841245024 PECOS PAC ID: 8123117744 Enrollment ID: I20160405002357 |
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