Primary Care of Ada, LLC

NPI #1851744312 in Ada, Oklahoma

Provider Information

NPI Number: 1851744312
Entity Type: Organization
Organization Name: Primary Care of Ada, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Jul 20, 2016
Last Updated: Dec 23, 2021

Practice Location

Address: 1705 CRADDUCK RD
City: Ada
State: Oklahoma
ZIP Code: 74820-9491
Phone: (580) 279-6313

Authorized Official

Name: RANDI IVY
Title: CREDENTIALING SPECIALIST
Phone: (580) 272-0485

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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