Individual
DR. JOHN DAVID GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1505 W ELK AVE, SUITE 1, ELIZABETHTON, TN 37643-2848
(423) 543-7919
(423) 543-5323
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD26505
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511836
—
TN
Enumeration date
08/20/2006
Last updated
01/17/2024
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