Abc Medical Clinic, Inc PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2096 Issued in OK

Legal business name

ABC MEDICAL CLINIC, INC PLLC

Practice address

1510 S Virginia Ave
Atoka, OK 74525-3246

Phone

(580) 889-3355

Fax

(580) 927-9941

NPI assigned

Jul 30, 2007

Organization subpart

No

Name

Ms. Linda L Heinze

Title

Office Manager

Phone

(580) 889-3355

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 9, 2013.

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1992995666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745250568",
            "telephone_number": "580-889-3355",
            "fax_number": "580-889-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S VIRGINIA AVE",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745253246",
            "telephone_number": "580-889-3355",
            "fax_number": "580-927-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC MEDICAL CLINIC, INC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "HEINZE",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "580-889-3355",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100747790C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.