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General NPI Number Information
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NPI Number | 1275528630
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE ASSOCIATES PC
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 01/23/2019
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Provider Practice Location Address
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Address Line | 4150 SE ADAMS RD
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City | BARTLESVILLE
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State | OK
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Zip | 74006-8410
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Country | US
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Telephone | 918-331-9979
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Fax | 918-331-2346
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Provider Business Mailing Address
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Address Line | 4150 SE ADAMS RD
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City | BARTLESVILLE
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State | OK
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Zip | 74006-8410
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Country | US
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Telephone | 918-331-9979
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Fax | 918-331-2346
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MAUREEN DANIEL
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Credential |
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Telephone | 918-331-2330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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