# RICHARD D. GREEN, MD, PC

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

## Provider details

- **NPI number:** 1508249947
- **Authorized official:** DR. RICHARD DEWAR GREEN M.D. (OWNER)
- **Authorized official phone:** (307) 577-4280

## Contact information

- **Practice address:** 940 E 3RD ST STE 102, CASPER, WY 82601-3200
- **Practice address phone:** (307) 577-4280
- **Practice address fax:** (307) 577-4283
- **Mailing address:** 940 E 3RD ST STE 102, CASPER, WY 82601-3200
- **Mailing address phone:** (307) 577-4280
- **Mailing address fax:** (307) 577-4283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 2373A | WY | Yes |

## Other

- **Enumeration date:** 07/02/2015
- **Last updated:** 07/02/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 106467300 | — | WY |