Individual
CHRISTOPHER B GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1530 LONE OAK RD, PADUCAH, KY 42003-7901
(270) 444-2793
Mailing address
1530 LONE OAK RD, PADUCAH, KY 42003-7901
(270) 444-2793
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
36140
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000602443
ANTHEM BCBS
KY
05
—
64093081
—
KY
01
—
P01044750
RAILROAD MEDICARE
KY
Enumeration date
02/22/2006
Last updated
09/11/2024
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