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NPI Code Detail

MEDICARE: VERNON CLINIC PLLC

MEDICARE: VERNON CLINIC PLLC
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 : 1992052039
Entity Type Code : Organization
Provider Name (Legal Business Name) : VERNON CLINIC PLLC
Provider Business Mailing Address
First Line : 1015 HILLCREST DR STE A
Second Line :
City : VERNON
State : TX
Zip : 76384-3165
Country : US
Telephone Number : 940-552-2530
Fax Number : 940-552-2539
Provider Business Practice Location Address
First Line : 1015 HILLCREST DR
Second Line :
City : VERNON
State : TX
Zip : 76384-3100
Country : US
Telephone Number : 940-552-2530
Fax Number : 940-552-2539
Authorized Official
Title or Position : OWNER/MEMBER
Name : ADANNA JULIET AMECHI-OBIGWE
Credential : M.D.
Telephone Number : 940-552-2530
Provider Enumeration Date : 08/08/2012
Last Update Date : 08/11/2020

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Directions to “VERNON CLINIC PLLC ” Practice Location

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