Individual
JOSEPH A GREENLEE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
11108 PARKVIEW CIRCLE DR, SUITE 5100, FORT WAYNE, IN 46845-1730
(260) 266-2800
(260) 266-2805
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01066643A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
24151
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000618052
ANTHEM
IN
05
—
200943540
—
IN
Enumeration date
10/20/2005
Last updated
10/20/2022
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