Individual
KEVIN CECIL GREENIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 BLOSSOM ST, WEBSTER, TX 77598-4204
(409) 772-5800
Mailing address
411 WALNUT ST # 15512, GREEN COVE SPRINGS, FL 32043-3443
(727) 432-3020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
ME93458
FL
207W00000X
Ophthalmology Physician
Primary
U1430
TX
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
D88314
MD
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
ME93458
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273351000
—
FL
Enumeration date
08/16/2005
Last updated
03/20/2023
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