Organization
URGENT CARE OF GREEN COUNTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN ROBERT KOVACS DO (PARTNER/CO OWNER)
(918) 274-8555
Entity
Organization
Contact information
Practice address
4115 REDDEN, PRYOR, OK 74361-9192
(918) 825-7555
(918) 825-7556
Mailing address
PO BOX 1044, OWASSO, OK 74055-1044
(918) 343-6000
(918) 343-6251
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200094640D
—
OK
01
—
200094640F
MEDICAID DME
OK
01
—
7835422
AETNA
OK
Enumeration date
09/19/2008
Last updated
11/19/2009
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