Organization
BENNY J GREEN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRY L MORSHEDI RHIT (PRACTICE MANAGER)
(501) 224-6727
Entity
Organization
Contact information
Practice address
14309 CANTRELL RD, STE 7, LITTLE ROCK, AR 72223
(501) 224-6727
(501) 224-0674
Mailing address
14309 CANTRELL RD, STE 7, LITTLE ROCK, AR 72223
(501) 224-6727
(501) 224-0674
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122497002
—
AR
01
—
CD8533
RAILROAD MEDICARE
—
Enumeration date
06/23/2006
Last updated
01/11/2016
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