Individual
DR. ROOSEVELT GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
751 PLEASANT ROW NW, HUNTSVILLE, AL 35816-2537
(256) 533-6311
Mailing address
PO BOX 18488, HUNTSVILLE, AL 35804-8488
(256) 534-8659
(256) 534-0276
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
08804
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-05234
BCBS
AL
05
—
630200045
—
AL
Enumeration date
07/27/2006
Last updated
10/14/2011
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