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Individual

DR. SANDRA D. GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2505 LARKIN RD STE 103, LEXINGTON, KY 40503-3256
(859) 600-1999
(859) 600-1998
Mailing address
2505 LARKIN RD STE 103, LEXINGTON, KY 40503-3256
(859) 339-8088
(859) 600-1998

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
41906
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100104650
KY
Enumeration date
07/27/2008
Last updated
01/31/2022
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