Provider Demographics
NPI:1710937743
Name:FEUERBORN & MCCRORY LLC
Entity Type:Organization
Organization Name:FEUERBORN & MCCRORY LLC
Other - Org Name:SEMINOLE FAMILY MEDICINE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:O
Authorized Official - Last Name:MCCRORY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-382-3650
Mailing Address - Street 1:2249 BOREN BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:OK
Mailing Address - Zip Code:74868-1927
Mailing Address - Country:US
Mailing Address - Phone:405-382-3650
Mailing Address - Fax:405-382-6028
Practice Address - Street 1:2249 BOREN BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-1927
Practice Address - Country:US
Practice Address - Phone:405-382-3650
Practice Address - Fax:405-382-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKDA0679OtherRR MEDICARE