Organization
GREEN COUNTRY MEDICAL, INC.
Active
Other names
Nowata County Rural Health Clinic and Green Country Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LACEE HAYES (BILLING)
(918) 273-0140
Entity
Organization
Contact information
Practice address
712 E OSAGE AVE, NOWATA, OK 74048-3638
(918) 273-0140
Mailing address
712 E OSAGE AVE, NOWATA, OK 74048-3638
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100739790A
NOWATA AM X-OVERS
OK
01
—
100739790B
SCV AM X-OVERS
OK
05
—
100739790G
—
OK
05
—
100739790H
—
OK
Enumeration date
04/11/2007
Last updated
07/16/2009
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