# BENNY J GREEN MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043246168
- **Authorized official:** MRS. SHERRY L MORSHEDI RHIT (PRACTICE MANAGER)
- **Authorized official phone:** (501) 224-6727

## Contact information

- **Practice address:** 14309 CANTRELL RD, STE 7, LITTLE ROCK, AR 72223
- **Practice address phone:** (501) 224-6727
- **Practice address fax:** (501) 224-0674
- **Mailing address:** 14309 CANTRELL RD, STE 7, LITTLE ROCK, AR 72223
- **Mailing address phone:** (501) 224-6727
- **Mailing address fax:** (501) 224-0674

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/23/2006
- **Last updated:** 01/11/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 122497002 | — | AR |
| 01 | — | CD8533 | RAILROAD MEDICARE | — |