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General NPI Number Information
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NPI Number | 1447796925
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Entity Type | Organization
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Legal Business Name | ADA MEDICAL GROUP PLLC
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 1601 N BROADWAY AVE
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City | ADA
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State | OK
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Zip | 74820-1403
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Country | US
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Telephone | 405-594-0191
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 N BROADWAY AVE
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City | ADA
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State | OK
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Zip | 74820-1403
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Country | US
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Telephone | 55-940-1914
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Fax | 877-466-2170
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICK O'NEIL
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Credential | D.O.
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Telephone | 580-332-8608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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