Individual
DR. WILLIAM THOMAS GREEN
Active
Individual
DR. WILLIAM THOMAS GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3120/T800
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0354674/6566685
—
OH
01
—
410047823
RAILROAD MEDICARE
OH
01
—
452082001
ADMINASTAR FEDERAL DMERC
OH
01
—
9321631
MEDICARE GROUP NUMBER
OH
Enumeration date
06/30/2006
Last updated
04/29/2008
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