| Dr Amanda Ruth Gorden Green, DO | |
|
395200 W 2900 Rd, Ochelata, OK 74051-2463 | |
| (918) 535-6000 | |
| (918) 535-2694 |
| Full Name | Dr Amanda Ruth Gorden Green |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 395200 W 2900 Rd, Ochelata, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740514306 | NPI | - | NPPES |
| 200348650 A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4906 (Oklahoma) | Primary |
| Entity Name | Cherokee Nation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780692723 PECOS PAC ID: 5799698742 Enrollment ID: O20031106000628 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Amanda Ruth Gorden Green, DO 395200 W 2900 Rd, Ochelata, OK 74051-2463 Ph: (918) 535-6000 | Dr Amanda Ruth Gorden Green, DO 395200 W 2900 Rd, Ochelata, OK 74051-2463 Ph: (918) 535-6000 |
Gregory S. Brooks, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 395200 W 2900 Rd, Ochelata, OK 74051 Phone: 918-535-6000 | |
Brandon Hart, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 395200 W 2900 Rd, Ochelata, OK 74051 Phone: 918-535-6000 | |
Dr. Amanda Bighorse, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 395200 W 2900 Rd, Ochelata, OK 74051 Phone: 918-535-6000 | |
Stephen Shannon, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 395200 W 2900 Rd, Ochelata, OK 74051 Phone: 918-535-6000 Fax: 918-535-2697 |