Family Care of Broken Arrow, Inc.
NPI #1053431452 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1053431452
- Entity Type
- Organization
- Organization Name
- Family Care of Broken Arrow, Inc.
- Primary Specialty
- Family Medicine
- Enumeration Date
- Mar 30, 2007
- Last Updated
- Apr 20, 2008
Practice Location
- Address
- 3100 S. ELM PL.
- Address 2
- SUITE A
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74012-7910
- Phone
- (918) 455-7777
Authorized Official
- Name
- DR. LEROY O. JESKE, D.O.
- Title
- MEDICAL DIRECTOR D.O.
- Phone
- (918) 455-7777
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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