Green Country Infectious Disease PC
NPI #1639639321 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1639639321
- Entity Type
- Organization
- Organization Name
- Green Country Infectious Disease PC
- Primary Specialty
- Internal Medicine - Infectious Disease
- Enumeration Date
- Mar 20, 2019
- Last Updated
- Apr 3, 2019
Practice Location
- Address
- 421 STONE WOOD DR
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74012-1026
- Phone
- (918) 872-8822
Authorized Official
- Name
- JANICE L BRACKEN
- Title
- CREDENTIALING
- Phone
- (918) 448-6160
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Infectious Disease — Infectious Disease |
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