# ADVANCED PRIMARY CARE CLINIC OF THE STOCKYARDS LLC

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

## Provider details

- **NPI number:** 1740980416
- **Authorized official:** VEDMIA FONKEM MD (OWNER)
- **Authorized official phone:** (405) 233-3745

## Contact information

- **Practice address:** 1506 S AGNEW AVE, OKLAHOMA CITY, OK 73108-2432
- **Practice address phone:** (405) 232-3745
- **Mailing address:** 1506 S AGNEW AVE, OKLAHOMA CITY, OK 73108-2432
- **Mailing address phone:** (405) 232-3745

## Taxonomy

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

## Other

- **Enumeration date:** 03/09/2023
- **Last updated:** 03/09/2023