# ADAM JONATHAN GREENE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1588386759
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA3082 | KY | Yes |
| 363A00000X | Physician Assistant | TC308 | KY | — |
| 363A00000X | Physician Assistant | — | NULL | — |

## Other

- **Enumeration date:** 09/14/2022
- **Last updated:** 03/01/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 300071350 | — | IN |
| 05 | — | 7100853770 | — | KY |