Individual
DR. STANLEY W GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 E 100 S, SALEM, UT 84653-8214
(801) 423-2310
Mailing address
2122 W 1800 N, PMB 305, CLINTON, UT 84015-7923
(801) 310-0153
(801) 776-3957
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
163990-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
163990-1205
UT
Other
Enumeration date
09/26/2005
Last updated
07/13/2010
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