Organization
INPATIENT PEDIATRIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MITRA GREEN M.D. (PHYSICIAN)
(318) 387-3453
Entity
Organization
Contact information
Practice address
3421 MEDICAL PARK DR, MONROE, LA 71203-2355
(318) 387-3453
(318) 323-9045
Mailing address
1601 LAMY LN, MONROE, LA 71201-3735
(318) 387-3453
(318) 323-9045
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1449725
—
LA
Enumeration date
07/01/2006
Last updated
07/20/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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