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 provides Medical Physician Assistant services 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