Individual
DARRYL A GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
212 HOSPITAL LN, SUITE 101, PERRYVILLE, MO 63775-1276
(573) 547-7888
(573) 547-7343
Mailing address
212 HOSPITAL LN, SUITE 101, PERRYVILLE, MO 63775-1276
(573) 547-7888
(573) 547-7343
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2004015323
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209293307
—
MO
01
—
P00213538
RAILROAD MEDICARE
MO
Enumeration date
08/10/2005
Last updated
04/14/2011
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