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General NPI Number Information
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NPI Number | 1801002118
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Entity Type | Organization
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Legal Business Name | ADA OUTPATIENT CLINIC, INC.
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 2901 ARLINGTON ST
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City | ADA
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State | OK
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Zip | 74820-2928
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Country | US
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Telephone | 580-332-8900
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Fax | 580-332-9052
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Provider Business Mailing Address
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Address Line | 2901 ARLINGTON ST
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City | ADA
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State | OK
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Zip | 74820-2928
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Country | US
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Telephone | 580-332-8900
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Fax | 580-332-9052
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. CYNTHIA ELAINE YARBERRY
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Credential |
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Telephone | 580-332-8900
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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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