| NPI | 1184933467 |
|---|---|
| Doing Business As | ARDMORE FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | VALERIE M MALONE Sopa Credentialing Manager 580-226-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 4120) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OK 4120) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2014-11-20 |