GREEN COUNTRY INFECTIOUS DISEASE PC (NPI# 1639639321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639639321 |
| Entity Type | Organization |
| Organization Name | GREEN COUNTRY INFECTIOUS DISEASE PC |
| Practice Address |
421 Stone Wood Dr Broken Arrow OK 74012-1026 |
| Mailing Address |
5908 S 298th East Ave Broken Arrow OK 74014-8405 |
| Practice Telephone | 9188728822 |
| Mailing Telephone | 9188728822 |
| Mailing Fax Number | 9188728823 |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-04-03 |
| Authorized Official Name | JANICE L BRACKEN (CREDENTIALING) |
| Authorized Official Telephone | 9184486160 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5908 S 298th East Ave, Broken Arrow, OK 740148405 | 9188728822 | 9188728823 |
| Street Address |
421 STONE WOOD DR |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74012-1026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154949139 | Bonnie Jordan James | Pharmacist | 915 E Kenosha St, Broken Arrow, OK 74012 | 2020-07-07 |
| 1548814874 | Flawless Smile Dentistry of Ba Pllc | Dentist | 2319 N. 9th Street, Broken Arrow, OK 74012 | 2019-07-25 |
| 1780236653 | Carefirst Pharmacy Inc. | Pharmacy | 2530 N. Elm Pl., Broken Arrow, OK 74012 | 2019-07-11 |
| 1043871213 | Stacy Lynn Mitchell | Counselor | 2035 W. Houson St., Suite A, Broken Arrow, OK 74012 | 2019-06-27 |
| 1497319297 | Sara Hart | Internal Medicine | 420 W. Stone Wood Drive, Broken Arrow, OK 74012 | 2019-04-26 |
| 1699262386 | Fulps Family Eye Care, LLC | Optometrist | 3300 S Aspen Ave Ste D, Broken Arrow, OK 74012 | 2018-04-18 |
| 1598284358 | Stephanie Sue Mcquarters | Clinical Medical Laboratory | 1840 South Lion Avenue, Broken Arrow, OK 74012 | 2017-09-13 |
| 1477072460 | Kama Rae Gettings | Nurse Practitioner | 4623 W. Kenosha St, Broken Arrow, OK 74012 | 2017-09-12 |
| 1689196727 | Kristen Sherie' Snyder | Case Manager/Care Coordinator | 1324 North Umbrella Avenue, Broken Arrow, OK 74012 | 2017-07-11 |
| 1699216754 | Hillside Wellness Plllp | Chiropractor | 2311 N 9th St, Suite 101, Broken Arrow, OK 74012 | 2017-03-09 |
| Find all providers in zip 74012 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932507605 | Id Consultants Pllc | Internal Medicine | 8609 Willow Springs Ct, Broken Arrow, OK 74011-8250 | 2014-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821236811 | Khawaja Omair Husain | Internal Medicine | 18205 Piedra Dr, Edmond, OK 73012-7633 | 2009-01-28 |
| 1669662672 | Infectious Disease and Pain Management of Tulsa | Internal Medicine | 1502 S Boulder Ave, Suite 206, Tulsa, OK 74119-4037 | 2007-07-26 |
| 1629288980 | Aline Brown M D P C | Internal Medicine | 3400 Nw Expressway St Ste 410, Oklahoma City, OK 73112-4491 | 2007-05-23 |
| 1265558779 | Mark Steven Dawson | Internal Medicine | 6120 S Yale Ave, Suite 1225, Tulsa, OK 74136-4234 | 2007-03-22 |
| 1013017292 | Vijay K Kolli | Internal Medicine | 1104e State Highway 152, Mustang, OK 73064-5116 | 2006-09-25 |
| 1538194725 | Infectious Disease Physicians PC | Internal Medicine | 729 So Blvd, Edmond, OK 73034 | 2006-07-12 |
| 1629047683 | Linda J Salinas | Internal Medicine | 920 Sl Young Blvd, Wp1160, Oklahoma City, OK 73104-5033 | 2006-03-14 |
| 1376517813 | Stanley N Schwartz | Internal Medicine | 5723 E 79th St, Tulsa, OK 74136-8432 | 2006-02-13 |
| 1588640965 | Karen K Kinney | Internal Medicine | 711 Stanton L Young Blvd, Ppb Suite 430, Oklahoma City, OK 73104-5023 | 2005-12-19 |
| 1033194451 | Mark Dillier Rowland | Internal Medicine | 6565 S Yale Ave Ste 912, Tulsa, OK 74136 | 2005-12-08 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN ARROW |
| Zip Code | 74012 |
Please comment or provide details below to improve the information on GREEN COUNTRY INFECTIOUS DISEASE PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.