| Green Country Medical, Inc | |
|
228 Willow South Coffeyville OK 74072 | |
| (918) 255-6000 | |
| Not Available |
| Full Name | Green Country Medical, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 228 Willow, South Coffeyville, Oklahoma |
| Authorized Official Name and Position | Sheryl Neely (RN) |
| Authorized Official Contact | 9182730140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Country Medical, Inc 712 E Osage Ave Nowata OK 74048-3638 Ph: () - | Green Country Medical, Inc 228 Willow South Coffeyville OK 74072 Ph: (918) 255-6000 |
| NPI Number | 1851514202 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 12/01/2009 |
| Medicare PECOS PAC ID | 2668508615 |
|---|---|
| Medicare Enrollment ID | O20100329000814 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851514202 | NPI | - | NPPES |
| 100739790H | Medicaid | OK | |
| 100739790F | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Green Country Medical, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 228 Willow, South Coffeyville, OK 74072 Phone: 918-255-6000 |