# GREEN COUNTRY PAIN MANAGEMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740722115
- **Authorized official:** LESLIE CHAN MD (SOLE MEMBER)
- **Authorized official phone:** (918) 935-3240

## Contact information

- **Practice address:** 6048-A S SHERIDAN RD, TULSA, OK 74145
- **Practice address phone:** (918) 935-3240
- **Practice address fax:** (918) 935-3241
- **Mailing address:** 6048-A S SHERIDAN RD, TULSA, OK 74145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 11/16/2016
- **Last updated:** 11/16/2016