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SOVEREIGN FAMILY CLINIC LLC NPI 1538450689


NPI Information

NPI: 1538450689
Provider Name: SOVEREIGN FAMILY CLINIC, LLC

Doing Business As: SOVEREIGN FAMILY PRACTICE CLINIC

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 37D2024679

Address:
1007 N COUNTRY CLUB RD
ADA, OK
ZIP 74820
Phone: (580) 421-8700
Get Directions

SOVEREIGN FAMILY CLINIC, LLC is a clinic center in Ada, OK. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SOVEREIGN FAMILY CLINIC, LLC NPI is 1538450689. The provider is registered as an organization entity type.
The provider Is Doing Business As Sovereign Family Practice Clinic.

The provider's business location address is:

1007 N COUNTRY CLUB RD
ADA, OK
ZIP 74820-847
Phone: (580) 421-8700
Fax: (580) 421-8785

The provider's authorized official is Chris M Anoatubby .
The authorized official title is President, Sovereign and has the following contact phone number (580) 272-5160.

The CLIA number assigned to this NPI record is 37D2024679 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/25/2011 and was last updated on 6/18/2015.


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
1261Q00000XClinic/CenterYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.