| Southern Oklahoma Internal Medicine P C | |
|
307 N Monte Vista St Ada OK 74820-4607 | |
| (580) 436-4495 | |
| (580) 436-4499 |
| Full Name | Southern Oklahoma Internal Medicine P C |
|---|---|
| Speciality | Internal Medicine |
| Location | 307 N Monte Vista St, Ada, Oklahoma |
| Authorized Official Name and Position | Barbara K Tuley (PRESIDENT) |
| Authorized Official Contact | 5804364495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Oklahoma Internal Medicine P C 307 N Monte Vista St Ada OK 74820-4607 Ph: (580) 436-4495 | Southern Oklahoma Internal Medicine P C 307 N Monte Vista St Ada OK 74820-4607 Ph: (580) 436-4495 |
| NPI Number | 1205971694 |
|---|---|
| Provider Enumeration Date | 02/21/2007 |
| Last Update Date | 12/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205971694 | NPI | - | NPPES |
| 500648296001 | Other | OK | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 17220 (Oklahoma) | Primary |
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