Advanced Primary Care Clinic of the Stockyards LLC
Organization Active NPI Family Medicine Physician · Oklahoma City, OK
NPI 1740980416 · NPPES record last updated Mar 9, 2023
Key facts
- NPI
- 1740980416
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ADVANCED PRIMARY CARE CLINIC OF THE STOCKYARDS LLC
- Practice address
- 1506 S Agnew Ave
Oklahoma City, OK 73108-2432 - Phone
- (405) 232-3745
- NPI assigned
- Mar 9, 2023
- Organization subpart
- No
Authorized official
- Name
- Vedmia Fonkem, MD
- Title
- Owner
- Phone
- (405) 233-3745
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1506 S Agnew Ave
Oklahoma City, OK 73108-2432
Mailing address
1506 S Agnew Ave
Oklahoma City, OK 73108-2432
Phone (405) 232-3745
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.