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: July 19, 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
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

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

The NPI number assigned to this healthcare provider is 1124531736, enumerated as an "organization" on November 06, 2017.

The provider is located at 1509 AUGUSTA DR ADA, OK 74820 and the phone number is (918) 728-4942.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.