| Ada Adult Medicine Clinic | |
|
721 Better Now Plz Ada OK 74820-2279 | |
| (580) 272-0025 | |
| (580) 272-6559 |
| Full Name | Ada Adult Medicine Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 721 Better Now Plz, Ada, Oklahoma |
| Authorized Official Name and Position | Bruce W Dennis (OWNER) |
| Authorized Official Contact | 5802720025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ada Adult Medicine Clinic 902 Arlington Ctr Pmb 224 Ada OK 74820-2883 Ph: (580) 272-0025 | Ada Adult Medicine Clinic 721 Better Now Plz Ada OK 74820-2279 Ph: (580) 272-0025 |
| NPI Number | 1689723959 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 04/19/2024 |
| Medicare PECOS PAC ID | 7517955453 |
|---|---|
| Medicare Enrollment ID | O20040501000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689723959 | NPI | - | NPPES |
| 200034380A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 18405 (Oklahoma) | Primary |
| Provider Name | Bruce W Dennis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760450555 PECOS PAC ID: 7416945357 Enrollment ID: I20040511000258 |
| Provider Name | Holly Katharyn Farrar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780209254 PECOS PAC ID: 2961826201 Enrollment ID: I20200721000543 |
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