Sovereign Family Clinic, LLC

NPI #1538450689 in Ada, Oklahoma

Provider Information

NPI Number: 1538450689
Entity Type: Organization
Organization Name: Sovereign Family Clinic, LLC
Primary Specialty: Clinic/Center
Enumeration Date: Apr 25, 2011
Last Updated: Jun 18, 2015

Practice Location

Address: 1007 N COUNTRY CLUB RD
City: Ada
State: Oklahoma
ZIP Code: 74820-2847
Phone: (580) 421-8700

Authorized Official

Name: MR. CHRIS M ANOATUBBY
Title: PRESIDENT, SOVEREIGN
Phone: (580) 272-5160

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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