Organization
GO GREENE ORTHOPEDICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK H GREENE III M.D. (OWNER)
(217) 479-5896
Entity
Organization
Contact information
Practice address
1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
(217) 479-5896
(217) 479-5892
Mailing address
1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
(217) 479-5896
(217) 479-5892
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
06/27/2011
Last updated
06/27/2011
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