Provider Demographics
NPI:1649334137
Name:TOTAL HEALTH CARE CLINIC PC
Entity type:Organization
Organization Name:TOTAL HEALTH CARE CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER,PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIAFFITELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-681-2273
Mailing Address - Street 1:10001 S PENNSYLVANIA AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6938
Mailing Address - Country:US
Mailing Address - Phone:405-834-4910
Mailing Address - Fax:405-681-2274
Practice Address - Street 1:10001 S PENNSYLVANIA AVE STE 170
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6938
Practice Address - Country:US
Practice Address - Phone:405-834-4910
Practice Address - Fax:405-681-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3345204D00000X
OK22740208D00000X
OKDC2616111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100006110AMedicaid
OK200008190AMedicaid
OKG30544Medicare UPIN