Individual
STEPHEN R. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 EAST VAN BUREN AVENUE, MCALESTER, OK 74501
(918) 426-0240
(918) 423-4051
Mailing address
6600 SOUTH YALE, SUITE 1400, TULSA, OK 74136
(918) 488-6001
(918) 488-6010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
26043
AL
207R00000X
Internal Medicine Physician
Primary
26629
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009962015
—
AL
05
—
200215670A
—
OK
Enumeration date
12/05/2006
Last updated
09/22/2014
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