Individual
CRAIG ROGER GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
260 E MAIN ST, JACKSON, OH 45640-1745
(740) 286-5022
(740) 286-7000
Mailing address
260 E MAIN ST, JACKSON, OH 45640-1745
(740) 286-5022
(740) 286-7000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4282/T1346
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0457400001
ADMINISTAR
OH
05
—
0862357
—
OH
Enumeration date
04/07/2006
Last updated
01/04/2023
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