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Organization

GREEN COUNTRY MEDICAL, INC.

Active
Other names
Green Country Medical Inc
Organization subpart
No

Provider details

NPI number
Authorized official
SHERYL NEELY (RN)
(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
05
100739790E
OK
05
100739790F
OK
01
100739790I
O-EPIC
OK
Enumeration date
04/11/2007
Last updated
05/09/2008
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