Individual
DR. GACHAVIS M GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
34 FRANKLIN RD, HATTIESBURG, MS 39402-1318
(601) 268-0400
(601) 264-3150
Mailing address
PO BOX 16235, HATTIESBURG, MS 39404-6235
(601) 268-0400
(601) 264-3150
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
5901002375
MI
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
80220
MS
Other
Enumeration date
01/11/2011
Last updated
02/24/2015
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