Individual
DR. JOHN A GREEN
Active
Individual
DR. JOHN A GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
011243
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014531
ANTHEM
VA
01
—
3037795
BLUE CROSS
TN
05
—
6093752
—
VA
Enumeration date
07/08/2005
Last updated
06/11/2014
Update your record
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