Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Green Country Infectious Disease PC

Organization Infectious Disease Physician · NPI 1639639321

Green Country Infectious Disease PC is an Infectious Disease Physician in Broken Arrow, Oklahoma. Works from 2 locations. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

421 Stone Wood Dr
Broken Arrow, OK 74012-1026
Phone: (918) 872-8822
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5908 S 298th East Ave, Broken Arrow, OK 74014-8405 — (918) 872-8822

Specialties & licences

Infectious Disease Physician (primary) Taxonomy 207RI0200X

Record details

NPI number1639639321
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Janice Bracken — Credentialing · (918) 448-6160
NPI enumeratedMarch 20, 2019
Last updated in NPPESApril 3, 2019
Mailing address5908 S 298th East Ave, Broken Arrow, OK 74014-8405

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