# PRIMECARE FAMILY CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407237704
- **Authorized official:** MRS. VALERIE MARIE MALONE CPC (OFFICE MANAGER)
- **Authorized official phone:** (580) 226-1010

## Contact information

- **Practice address:** 1405 4TH AVE NW \# 311, ARDMORE, OK 73401-2708
- **Practice address phone:** (580) 490-3336
- **Practice address fax:** (580) 490-3342
- **Mailing address:** 1019 15TH AVE NW, ARDMORE, OK 73401-1810
- **Mailing address phone:** (580) 490-3336
- **Mailing address fax:** (580) 490-3342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/11/2015
- **Last updated:** 06/11/2015