Organization
GREEN COUNTRY RADIOLOGY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD KNEPPER MD (PRESIDENT)
(918) 664-9892
Entity
Organization
Contact information
Practice address
129 N KENTUCKY ST, PRYOR, OK 74361-4211
(918) 664-9892
(918) 664-2521
Mailing address
4500 S GARNETT RD, STE 300, TULSA, OK 74146-5229
(918) 664-9892
(918) 664-2521
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100742290A
—
OK
Enumeration date
04/24/2006
Last updated
03/12/2010
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