| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1509 Augusta Dr, Ada, Oklahoma |
| Authorized Official Name and Position | Valerie M Pack (FAMILY PHYSICIAN) |
| Authorized Official Contact | 9187284942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1509 Augusta Dr Ada OK 74820-8576 Ph: (918) 728-4942 | 1509 Augusta Dr Ada OK 74820-8576 Ph: (918) 728-4942 |
| NPI Number | 1124531736 |
|---|---|
| Provider Enumeration Date | 11/06/2017 |
| Last Update Date | 08/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124531736 | NPI | - | NPPES |
| 200654670A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5857 (Oklahoma) | Primary |
Ada Family Medical Center, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 530 N Monte Vista St, Ada, OK 74820 Phone: 580-310-9510 Fax: 580-436-4447 | |
Central Oklahoma Family Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 N Monte Vista St, Ada, OK 74820 Phone: 580-436-5111 Fax: 580-925-9149 | |
Central Oklahoma Family Medical Center, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 Colony Drive Bldg, Ada, OK 74820 Phone: 580-925-3286 | |
Myhealth Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1601 N Broadway Ave, Ada, OK 74820 Phone: 405-594-0191 | |