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ADA PEDIATRIC CLINIC NPI 1255671806


NPI Information

NPI: 1255671806
Provider Name: ADA PEDIATRIC CLINIC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 37D2012393

Address:
1414 ARLINGTON ST
SUITE 1700
ADA, OK
ZIP 74820
Phone: (580) 332-7337
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ADA PEDIATRIC CLINIC is a pediatrics in Ada, OK. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. ADA PEDIATRIC CLINIC NPI is 1255671806. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1414 ARLINGTON ST
SUITE 1700
ADA, OK
ZIP 74820-646
Phone: (580) 332-7337
Fax: (580) 332-3881

The provider's authorized official is Ruth Weesner .
The authorized official title is Owner and has the following contact phone number (580) 332-7337.

The CLIA number assigned to this NPI record is 37D2012393 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/19/2013 and was last updated on 2/19/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics16267OKLAHOMAYes
2363LP0200XNurse PractitionerPediatrics0065815OKLAHOMANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1100130860BMEDICAIDOKLAHOMA
2200055950AMEDICAIDOKLAHOMA
3E82151MEDICARE UPINOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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