# DR MICHAEL R GREEN PC

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

## Provider details

- **NPI number:** 1306964135
- **Authorized official:** MICHAEL R GREEN MD (PRESIDENT)
- **Authorized official phone:** (435) 688-0156

## Contact information

- **Practice address:** 1490 E FOREMASTER DR, 260, ST GEORGE, UT 84790-4488
- **Practice address phone:** (435) 688-0156
- **Practice address fax:** (435) 688-0330
- **Mailing address:** 1490 E FOREMASTER DR, 260, ST GEORGE, UT 84790-4488
- **Mailing address phone:** (435) 688-0156
- **Mailing address fax:** (435) 688-0330

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 287502-1205 | UT | Yes |

## Other

- **Enumeration date:** 03/27/2007
- **Last updated:** 07/30/2010