Individual
REBECCA L GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8200 W CENTRAL AVE, SUITE 1, WICHITA, KS 67212-9503
(316) 722-6260
(316) 721-8307
Mailing address
8200 W CENTRAL AVE, SUITE 1, WICHITA, KS 67212-9503
(316) 722-6260
(316) 721-8307
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
430254
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104135
BLUE CROSS BLUE SHIELD
KS
01
—
OOS22419
PREFERRED HEALTH SYSTEMS
KS
01
—
P00182568
TRAVELERS MEDICARE
KS
Enumeration date
08/12/2006
Last updated
07/08/2007
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