Organization
ADA ANESTHESIA ASSOCIATES, PLLC
Active
Organization
ADA ANESTHESIA ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERI LYN YATES (OFFICE MANAGER)
(580) 272-0485
Entity
Organization
Contact information
Practice address
430 N MONTE VISTA ST, ADA, OK 74820-4657
(580) 272-0485
(580) 332-5750
Mailing address
PO BOX 1386A, ADA, OK 74821-4913
(580) 272-0485
(580) 332-5750
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200267160A
—
OK
Enumeration date
06/08/2007
Last updated
02/02/2012
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