| Cms Outpatient Clinic Inc. | |
|
201 N Monte Vista St Suite C Ada OK 74820-7220 | |
| (580) 310-0015 | |
| (580) 310-0909 |
| Full Name | Cms Outpatient Clinic Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 201 N Monte Vista St, Ada, Oklahoma |
| Authorized Official Name and Position | Michael R, Stafford (PHYSICIAN) |
| Authorized Official Contact | 5803100015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cms Outpatient Clinic Inc. 201 N Monte Vista St Suite C Ada OK 74820-7220 Ph: (580) 310-0015 | Cms Outpatient Clinic Inc. 201 N Monte Vista St Suite C Ada OK 74820-7220 Ph: (580) 310-0015 |
| NPI Number | 1154489540 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 08/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154489540 | NPI | - | NPPES |
| 200039450B | Medicaid | OK | |
| 200039450A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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