Ada Family Medical Center, PLLC

Organization Active NPI Family Medicine Physician · Ada, OK

NPI 1023063997 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1023063997
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
3540 (OK)
Legal business name
ADA FAMILY MEDICAL CENTER, PLLC
Practice address
530 N Monte Vista St
Ada, OK 74820-4612
Phone
(580) 310-9510
Fax
(580) 436-4447
NPI assigned
May 22, 2006
Organization subpart
No

Authorized official

Name
Dr. Marc Jason Davis, D.O.
Title
Owner / Physician
Phone
(580) 310-9510

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 3540 OK Yes

Addresses

Primary practice location

530 N Monte Vista St
Ada, OK 74820-4612

Mailing address

530 N Monte Vista St
Ada, OK 74820-4612
Phone (580) 310-9510

Other providers in Ada, OK

All providers in Ada, OK · Family Medicine Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.