Individual
JAMES WALTER GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3215 SHRINE RD STE 3, BRUNSWICK, GA 31520-4300
(912) 434-9164
(912) 434-9386
Mailing address
1015 ARTHUR J MOORE DR # 2, SAINT SIMONS ISLAND, GA 31522-2206
(912) 434-9164
(912) 434-9386
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
029657
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000382687B
—
GA
01
—
202I085437
MEDICARE PTAN
GA
Enumeration date
10/04/2006
Last updated
09/22/2022
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