Individual
DR. KELLY RAY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19087B GREENO RD, FAIRHOPE, AL 36532-3899
(251) 928-5568
(251) 928-2605
Mailing address
19087B GREENO RD, FAIRHOPE, AL 36532-3899
(251) 928-5568
(251) 928-2605
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27194
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118675
—
AL
Enumeration date
10/13/2006
Last updated
08/10/2015
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