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Individual

DR. BRANDON GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
410 N STATE OF FRANKLIN RD, SUITE 130, JOHNSON CITY, TN 37604-6971
(423) 431-2477
Mailing address
36 SANCTUARY CT, JOHNSON CITY, TN 37615-4191
(423) 444-5047

Taxonomy

Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
074287
GA
207XP3100X
Pediatric Orthopaedic Surgery Physician
DO2176
TN

Other

Enumeration date
10/01/2009
Last updated
09/23/2016
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