Organization
URGENT CARE OF GREEN COUNTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN ROBERT KOVACS DO (OWNER)
(918) 274-8555
Entity
Organization
Contact information
Practice address
11717 SOUTH MEMORIAL, BIXBY, OK 74008
(918) 369-9555
(918) 369-9556
Mailing address
PO BOX 1044, OWASSO, OK 74055
(918) 274-8555
(918) 274-8556
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200094640A
—
OK
01
—
200094640E
MEDICAID DME
OK
01
—
7835422
AETNA
OK
Enumeration date
01/22/2007
Last updated
05/10/2013
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