Provider Demographics
NPI:1760912075
Name:TOTAL CARE PHYSICIANS GROUP
Entity Type:Organization
Organization Name:TOTAL CARE PHYSICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE SENSEI
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-982-8333
Mailing Address - Street 1:2601 N ASPEN AVE STE 1011
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-1127
Mailing Address - Country:US
Mailing Address - Phone:918-921-5535
Mailing Address - Fax:918-921-5537
Practice Address - Street 1:2601 N ASPEN AVE STE 1011
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-1127
Practice Address - Country:US
Practice Address - Phone:918-638-0399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-19
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty