Organization
GREGORY CHAD GREEN OD
Active
Other names
Green Family Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. G CHAD GREEN O.D. (OWNER)
(334) 289-0466
Entity
Organization
Contact information
Practice address
1401 US HIGHWAY 80 WEST, DEMOPOLIS, AL 36732-4127
(334) 289-0466
(334) 289-5588
Mailing address
1401 US HIGHWAY 80 WEST, DEMOPOLIS, AL 36732-4127
(334) 289-0466
(334) 289-5588
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-773-TA-219
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01D1083392
CLIA ID NUMBER
AL
05
—
529920020
—
AL
Enumeration date
11/20/2006
Last updated
07/14/2022
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