Individual
DR. RONA RENELL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
67 W. CAMPBELLTON ST., FAIRBURN, GA 30213
(770) 964-2201
(770) 306-9744
Mailing address
PO BOX 188, FAIRBURN, GA 30213-0188
(770) 964-2201
(770) 306-9744
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
000697
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000697
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000558467A
—
GA
01
—
25127
COVENTRY GEORGIA
GA
01
—
2700177
UNITED HEALTH CARE GA
GA
01
—
4355747
AETNA GEORGIA
GA
01
—
451998
BCBS GEORGIA
GA
01
—
51510661
AL BLUE CROSS BLUE SHEILD
AL
01
—
515129440
AL BCBS (ROANOKE OFFICE)
AL
01
—
57106
TRICARE GEORGIA
GA
Enumeration date
10/04/2006
Last updated
04/24/2008
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