Individual
DR. MICHAEL D GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 W MAPLE AVE, SUITE 703, SPRINGDALE, AR 72764-5335
(479) 750-2203
(479) 750-1193
Mailing address
601 WEST MAPLE AVE., SUITE 703, SPRINGDALE, AR 72764
(479) 750-2203
(479) 750-1193
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
C7697
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100078010A
—
OK
05
—
117593001
—
AR
01
—
168460000
QUAL CHOICE
AR
05
—
208228700
—
MO
01
—
C7697
AR STATE LICENSE
AR
Enumeration date
06/16/2006
Last updated
03/07/2023
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