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Individual

BRIAN A GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1661 INTERNATIONAL PLACE DRIVE, SUITE 350, MEMPHIS, TN 38120
(901) 685-2696
(901) 682-9747
Mailing address
1661 INTERNATIONAL PLACE DRIVE, SUITE 350, MEMPHIS, TN 38120
(901) 685-2696
(901) 682-9747

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
MD0000046433
TN
2085R0202X
Diagnostic Radiology Physician
2004005488
MO
2085R0202X
Diagnostic Radiology Physician
49303
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
127217
BLUE CHOICE
MO
05
201269206
MO
01
751786
HEALTHLINK
MO
Enumeration date
07/10/2006
Last updated
11/21/2024
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