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General NPI Number Information
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NPI Number | 1992414155
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Entity Type | Organization
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Legal Business Name | ADC MEDICAL OBG LLC
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 5010 E 68TH ST STE 200
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City | TULSA
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State | OK
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Zip | 74136-3305
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Country | US
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Telephone | 918-960-2827
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Fax | 918-960-2824
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Provider Business Mailing Address
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Address Line | 5010 E 68TH ST STE 200
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City | TULSA
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State | OK
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Zip | 74136-3305
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Country | US
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Telephone | 918-960-2827
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Fax | 918-960-2824
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Authorized Official
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Title or Position | BILLING/CREDENTIALING MANAGER
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Name | JENNIFER CAIN
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Credential |
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Telephone | 918-960-2827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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