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Individual

DR. DANIEL JOSEPH GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
865 S 1ST ST, JESUP, GA 31545-0210
(912) 530-3176
Mailing address
865 S 1ST ST, JESUP, GA 31545-0210
(912) 530-3176

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
53230
GA
207Q00000X
Family Medicine Physician
Primary
053230
GA

Other

Enumeration date
11/02/2005
Last updated
08/22/2016
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