| Abundant Life Family Medicine | |
|
520 N Monte Vista St Suite A Ada OK 74820-4674 | |
| (580) 272-0922 | |
| (580) 272-0811 |
| Full Name | Abundant Life Family Medicine |
|---|---|
| Speciality | Clinic/center |
| Location | 520 N Monte Vista St, Ada, Oklahoma |
| Authorized Official Name and Position | Leandrita Flores Ortega (MANAGER) |
| Authorized Official Contact | 5802720922 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Abundant Life Family Medicine 520 N Monte Vista St Suite A Ada OK 74820-4674 Ph: (580) 272-0922 | Abundant Life Family Medicine 520 N Monte Vista St Suite A Ada OK 74820-4674 Ph: (580) 272-0922 |
| NPI Number | 1770609042 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 02/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770609042 | NPI | - | NPPES |
| 200102180A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 23586 (Oklahoma) | Primary |
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