Individual
DR. JEFFREY D GREENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
625 E BROADWAY ST, JACKSON, WY 83001-0428
(307) 733-3636
Mailing address
PO BOX 428, 625 E BROADWAY, JACKSON, WY 83001-0428
(307) 733-3636
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
6444A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115562800
—
WY
Enumeration date
08/17/2006
Last updated
02/03/2021
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