Individual
DR. GARY HOWARD GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3450 N GLASSFORD HILL RD STE E, PRESCOTT VALLEY, AZ 86314-1351
(928) 499-3152
Mailing address
3943 N WAKEFIELD DR, PRESCOTT VALLEY, AZ 86314-6733
(480) 296-4646
(480) 505-0922
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
AZ0810
AZ
152WC0802X
Corneal and Contact Management Optometrist
AZ0810
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088458
AHCCCS
AZ
01
—
137085
AHCCS
AZ
05
—
137085
—
AZ
01
—
AZ0179560
BLUE CROSS BLUE SHIELD
AZ
01
—
AZ0810
EYE MED
AZ
01
—
P00276390
RAILROAD MEDICARE
AZ
Enumeration date
08/18/2005
Last updated
01/28/2026
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