Individual
DR. VALERIE MARIE PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 276-1846
(580) 559-0864
Mailing address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 276-1846
(580) 559-0864
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5857
OK
207Q00000X
Family Medicine Physician
Primary
5857
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200654670A
—
OK
Enumeration date
04/01/2015
Last updated
08/23/2021
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