Organization
GARY PADDACK MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY PADDACK MD (OWNER)
(580) 436-2262
Entity
Organization
Contact information
Practice address
902 ARLINGTON CTR, PMB 224, ADA, OK 74820-2883
(580) 436-2262
(580) 272-0186
Mailing address
902 ARLINGTON CTR, PMB 224, ADA, OK 74820-2883
(580) 436-2262
(580) 272-0186
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200034360A
—
OK
Enumeration date
01/09/2007
Last updated
01/11/2008
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