Provider Demographics
NPI:1750504924
Name:FIRSTCARE MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:FIRSTCARE MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CHIAFFITELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-681-2273
Mailing Address - Street 1:1616 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3600
Mailing Address - Country:US
Mailing Address - Phone:405-681-2273
Mailing Address - Fax:405-681-2274
Practice Address - Street 1:1616 S STATE ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3600
Practice Address - Country:US
Practice Address - Phone:405-681-2273
Practice Address - Fax:405-681-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3345207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK600522397Medicare PIN