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Individual

ROY MACK GREENWAY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, FACS

Contact information

Practice address
401 SW 80TH ST STE 101, OKLAHOMA CITY, OK 73139-8123
(405) 601-5169
(405) 601-9095
Mailing address
PO BOX 2339, ELK CITY, OK 73648-2339
(580) 225-2517
(580) 225-3167

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
23986
OK
208600000X
Surgery Physician
Primary
23986
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200196600A
OK
Enumeration date
02/07/2007
Last updated
11/11/2022
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