Benny Ross Wofford, PA
Physician Assistant in Ada, OK. Individual provider (NPI-1).
NPI number1104871995
StatusActive
Last updated in NPPESOct 30, 2025
Details
- NPI
- 1104871995
- Entity type
- Individual (NPI-1)
- Name
- Mr. Benny Ross Wofford
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 23, 2006
- Certification date
- Oct 30, 2025
- Last updated
- Oct 30, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 1031 | OK | Yes |
Practice location
1921 Stonecipher BlvdAda, OK 74820-3439
Phone 580-436-3980
Mailing address
1921 Stonecipher BlvdAda, OK 74820-3439
Phone 580-436-3980
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