Organization
DANIEL GREEN MD
Active
Organization
DANIEL GREEN MD
Active
Other names
Lake County Internal Medicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL P GREEN MD (OWNER DIRECTOR)
(731) 285-2324
Entity
Organization
Contact information
Practice address
305 E TICKLE ST, DYERSBURG, TN 38024-3117
(731) 285-2324
(731) 660-8739
Mailing address
1804 HIGHWAY 45 BYP, SUITE 604, JACKSON, TN 38305-4436
(731) 660-8759
(731) 660-8739
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5993
TN
Other
Enumeration date
11/07/2006
Last updated
08/22/2020
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