Organization · Type 2 NPI
Green's Country Clinic, LLC
Medical Physician Assistant · Blackwell, OK
NPI number
1093240749
Active
Practice location
223 E Blackwell Ave
Blackwell, OK 74631-2909
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 800 (OK) |
Medical Physician Assistant: Definition to come...
About NPI 1093240749
Green's Country Clinic, LLC's National Provider Identifier is 1093240749, issued on May 1, 2017. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Blackwell, OK. The record was last updated on May 1, 2017.