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 NPI 1801383005
Title
Owner
Phone
(405) 233-3745

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Oklahoma City, OK

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

Sources for this page

Verify at the official NPI Registry.