Organization
PRIMARY CARE OF ADA, LLC
Active
Organization
PRIMARY CARE OF ADA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDI IVY (CREDENTIALING SPECIALIST)
(580) 272-0485
Entity
Organization
Contact information
Practice address
1705 CRADDUCK RD, ADA, OK 74820-9491
(580) 279-6313
Mailing address
1705 CRADDUCK RD STE B, ADA, OK 74820-9491
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/20/2016
Last updated
12/23/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up