Organization
GREEN COUNTRY EMERGENCY PHYSICIANS GROUP OF TULSA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY D DIXON MD (MANAGING MEMBER)
(918) 728-3354
Entity
Organization
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104
(918) 579-1000
(918) 664-2521
Mailing address
1145 S UTICA AVE STE 365, TULSA, OK 74104-4004
(918) 728-3354
(918) 728-7554
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200094670A
—
OK
Enumeration date
10/03/2006
Last updated
06/01/2018
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