Organization
GREEN COUNTRY PAIN MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE CHAN MD (SOLE MEMBER)
(918) 935-3240
Entity
Organization
Contact information
Practice address
6048-A S SHERIDAN RD, TULSA, OK 74145
(918) 935-3240
(918) 935-3241
Mailing address
6048-A S SHERIDAN RD, TULSA, OK 74145
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
11/16/2016
Last updated
11/16/2016
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