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Individual
JOHN ROBERT GREEN IV
Active
Individual
JOHN ROBERT GREEN IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD-52906
IA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
MD-52906
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
03/21/2019
Last updated
08/08/2024
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