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

Phil James Green, PAC

Individual provider Family Medicine Physician · NPI 1083610752

Phil James Green, PAC is a Physician Assistant in Blackwell, Oklahoma. Qualified in 1996, 30 years ago. Accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
30
Licensed in
OK
In the registry since
2005
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Practice location Address checks out

1009 W Ferguson Ave
Blackwell, OK 74631-5602
Phone: (580) 363-0052
Fax: (580) 363-0894
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence PA800 (OK)

Record details

NPI number1083610752
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedJune 27, 2005
Last updated in NPPESJuly 13, 2026
Mailing address1009 W Ferguson Ave, Blackwell, OK 74631-5602

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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