OrganizationActive
Ada Gynecology & Obstetrics
NPI 1881717544 · Preferred Provider Organization · Ada, OK
Provider details
- NPI number
- 1881717544
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Jimmy Wallace, Owner(580) 436-9088
- License
- 8279 (OK)
Specialties & taxonomies
Managed Care Organizations
Practice location
1414 Arlington St Ste 1700
Ada, OK 74820-2694
Phone: (580) 436-9088
Fax: (580) 436-0035
Approximate (ZIP-level) locationGet directions
Mailing address
1414 Arlington St Ste 1700
Ada, OK 74820-2694
Registry dates
- Enumerated
- 2007-04-09
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.