OrganizationActive
Green Country Infectious Disease PC
NPI 1639639321 · Infectious Disease Physician · Broken Arrow, OK
Provider details
- NPI number
- 1639639321
- Entity type
- Organization
- Primary specialty
- Infectious Disease PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Janice Bracken, Credentialing
Mailing address
5908 S 298th East Ave
Broken Arrow, OK 74014-8405
Registry dates
- Enumerated
- 2019-03-20
- Last updated
- 2019-04-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.