Individual
ADAM JONATHAN GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
130 STONECREST RD STE 106, SHELBYVILLE, KY 40065-8126
(502) 647-7708
(502) 647-7747
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3082
KY
363A00000X
Physician Assistant
TC308
KY
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300071350
—
IN
05
—
7100853770
—
KY
Enumeration date
09/14/2022
Last updated
03/01/2023
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