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General NPI Number Information
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NPI Number | 1528417409
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Entity Type | Organization
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Legal Business Name | VALLEY FAMILY CLINIC INC
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 106 BURR AVE
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City | PAULS VALLEY
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State | OK
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Zip | 73075-3848
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Country | US
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Telephone | 405-238-4633
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Fax | 405-238-4690
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Provider Business Mailing Address
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Address Line | 106 BURR AVE
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City | PAULS VALLEY
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State | OK
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Zip | 73075-3848
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Country | US
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Telephone | 405-238-4633
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Fax | 405-238-4690
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN J JONES
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Credential | D.O.
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Telephone | 405-238-4633
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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 | OK
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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 | OK
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