Organization
JAMES W GREENE MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES WALTER GREENE MD (PRESIDENT)
(912) 434-9164
Entity
Organization
Contact information
Practice address
3215 SHRINE RD STE 3, BRUNSWICK, GA 31520-4300
(912) 434-9164
(912) 434-9386
Mailing address
1015 ARTHUR J MOORE DR # 2, SAINT SIMONS IS, GA 31522-2206
(912) 434-9164
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
029657
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202G702594
MEDICARE GROUP PTAN
GA
Enumeration date
04/25/2014
Last updated
07/08/2022
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