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

Green's Country Clinic, LLC

Organization Medical Physician Assistant · NPI 1093240749

Green's Country Clinic, LLC is a Medical Physician Assistant in Blackwell, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2017.

Licensed in
OK
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

223 E Blackwell Ave
Blackwell, OK 74631-2909
Phone: (580) 363-0943
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 800 (OK)

Record details

NPI number1093240749
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Phil Green — Physician Assistant · (580) 363-0943
NPI enumeratedMay 1, 2017
Last updated in NPPESMay 1, 2017
Mailing address223 E Blackwell Ave, Blackwell, OK 74631-2909

Other providers in Blackwell