Healthcare Provider Details

I. General information

NPI: 1336293067
Provider Name (Legal Business Name): URGENT CARE OF GREEN COUNTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 05/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

985 W WILL ROGERS BLVD
CLAREMORE OK
74017
US

IV. Provider business mailing address

PO BOX 1044
OWASSO OK
74055
US

V. Phone/Fax

Practice location:
  • Phone: 918-343-6000
  • Fax: 918-343-6251
Mailing address:
  • Phone: 918-274-8555
  • Fax: 918-274-8556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateOK

VIII. Authorized Official

Name: STEPHEN ROBERT KOVACS
Title or Position: OWNER
Credential: DO
Phone: 918-274-8555