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NPI Code Detail

MEDICARE: ADA OUTPATIENT CLINIC, INC.

MEDICARE: ADA OUTPATIENT CLINIC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

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

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Directions to “ADA OUTPATIENT CLINIC, INC. ” Practice Location

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