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Individual

DR. MARK W GREENE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
51681 HUNTINGTON RD, LA PINE, OR 97739-9626
(541) 536-7399
Mailing address
1100 NW 12TH ST, FRUITLAND, ID 83619-5040
(208) 452-2662

Taxonomy

Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
MD156287
OR
208200000X
Plastic Surgery Physician
J2037
TX

Other

Enumeration date
05/01/2006
Last updated
02/25/2020
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