Individual
THOMAS RICHARD GREEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-2345
Mailing address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
01031243A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100094270
—
IN
Enumeration date
08/10/2005
Last updated
04/23/2024
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