Individual
DANIEL P GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 E TICKLE ST, DYERSBURG, TN 38024-3117
(731) 285-2324
(731) 285-1440
Mailing address
305 E TICKLE ST, DYERSBURG, TN 38024-3117
(731) 285-2324
(731) 285-1440
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5993
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3155396
—
TN
Enumeration date
11/07/2006
Last updated
07/31/2008
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