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FAMILY PHYSICIAN
NPI 1124531736
Family Medicine in Ada, OK

Active since November 06, 2017
1509 AUGUSTA DR, ADA, OK 74820(918) 728-4942(918) 770-8456 Get Directions Write a Review

NPPES record last updated: August 23, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 23, 2021, Nov 6, 2017 (2 updates tracked since 2017).

About Family Physician NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY PHYSICIAN (NPI 1124531736) is a healthcare organization registered as a family medicine in Ada, Oklahoma and active in the NPI registry since November 2017. The organization lists Valerie M Pack, Family Physician, as its authorized official.

NPPES Registry Identity

NPI1124531736
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePACK FAMILY CLINIC, PLLC
Location Address1509 AUGUSTA DRAda, OK 74820-8576
Mailing Address1509 Augusta DrAda, OK 74820-8576 · (918) 728-4942 · Fax (918) 770-8456
Phone(918) 728-4942
Fax(918) 770-8456
Organization SubpartNo
Authorized OfficialValerie M PackFamily Physician · (918) 728-4942
Enumeration DateNovember 6, 2017
Last NPPES UpdateAugust 23, 20212 updates tracked since enumeration
NPPES CertifiedAugust 23, 2021
✔ NPI 1124531736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OK · 5857
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1509 AUGUSTA DR, Ada, OK 74820
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Other Names 1

Doing Business AsFamily Physician

Other Identifiers 1

Medicaid200654670AOK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pack Family Clinic, PLLC's NPI number?

The NPI number for Pack Family Clinic, PLLC is 1124531736. It was assigned to this organization in the NPPES registry on November 6, 2017. The provider is doing business as Family Physician.

Where is Pack Family Clinic, PLLC located?

Pack Family Clinic, PLLC is located at 1509 Augusta Dr, Ada, OK 74820. The listed phone number is (918) 728-4942.

What is Pack Family Clinic, PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Pack Family Clinic, PLLC was last updated on August 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.