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Individual

DR. R MICHAEL GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
280 FORT SANDERS WEST BLVD, SUITE 101, KNOXVILLE, TN 37922-3398
(865) 539-0270
(865) 539-6998
Mailing address
280 FORT SANDERS WEST BLVD, SUITE 101, KNOXVILLE, TN 37922-3351
(865) 539-0270
(865) 539-6998

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
28506
TN
208000000X
Pediatrics Physician
Primary
28506
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3817540
TN
Enumeration date
05/25/2006
Last updated
04/05/2023
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