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Individual

JOHN WILLOCK GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
561 W CENTRAL AVE, DELAWARE, OH 43015-1410
(740) 615-2141
(740) 615-2142
Mailing address
561 W CENTRAL AVE, DELAWARE, OH 43015-1410
(740) 615-2141
(740) 615-2142

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35.081269
OH
208M00000X
Hospitalist Physician
Primary
35081269
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2411947
OH
Enumeration date
11/18/2005
Last updated
01/05/2022
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