NPI 1255671806 · live from the CMS NPI Registry
Ada Pediatric Clinic
Pediatrics in Ada, OK. National Provider Identifier 1255671806, active.
NPI record
| NPI | 1255671806 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics 208000000X |
| Practice location | 1414 Arlington St, Suite 1700, Ada, OK 74820 |
| Practice phone | 580-332-7337 |
| Enumerated | February 19, 2013 |
| Last updated | February 19, 2013 |
| Authorized official | Ruth Weesner, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics | 363LP0200X | 0065815 (OK) |
| Pediatrics primary | 208000000X | 16267 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.