Individual
BENNY J GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14309 CANTRELL RD, LITTLE ROCK, AR 72223-4230
(501) 224-6727
(501) 224-0374
Mailing address
14309 CANTRELL RD, SUITE 7, LITTLE ROCK, AR 72223-4217
(501) 224-6727
(501) 224-0374
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C6412
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080017867
RAILROAD MEDICARE
AR
05
—
101838001
—
AR
Enumeration date
07/01/2005
Last updated
01/11/2016
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