| Sovereign Family Practice Clinic | |
|
1007 N Country Club Rd Ada OK 74820-2847 | |
| (580) 421-8700 | |
| (580) 421-8785 |
| Full Name | Sovereign Family Practice Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 1007 N Country Club Rd, Ada, Oklahoma |
| Authorized Official Name and Position | Chris M Anoatubby (PRESIDENT, SOVEREIGN) |
| Authorized Official Contact | 5802725160 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sovereign Family Practice Clinic 1007 N Country Club Rd Ada OK 74820-2847 Ph: (580) 421-8700 | Sovereign Family Practice Clinic 1007 N Country Club Rd Ada OK 74820-2847 Ph: (580) 421-8700 |
| NPI Number | 1538450689 |
|---|---|
| Provider Enumeration Date | 04/25/2011 |
| Last Update Date | 06/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538450689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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