Individual
JACK J GREENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2121 JUAN TABO NE, ALBUQUERQUE, NM 87112
(505) 237-8800
(505) 237-8803
Mailing address
PO BOX 26028, ALBUQUERQUE, NM 87125-6028
(505) 262-7963
(505) 232-1627
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
81-212
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30775
—
NM
Enumeration date
07/26/2006
Last updated
07/02/2025
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