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Individual
DR. JOHN GREEN III
Active
Individual
DR. JOHN GREEN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
056998
GA
207Q00000X
Family Medicine Physician
OS008848L
PA
207QA0505X
Adult Medicine Physician
Primary
21492
MS
Other
Enumeration date
06/06/2006
Last updated
06/17/2011
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