Organization
GREEN SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL EDWARD GREEN MD (OWNER)
(615) 452-1602
Entity
Organization
Contact information
Practice address
854 LONE OAK DRIVE, GALLATIN, TN 37066
(615) 452-1602
(615) 451-0139
Mailing address
854 LONE OAK DRIVE, GALLATIN, TN 37066
(615) 452-1602
(615) 451-0139
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0000000110
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3158726
BCBS
TN
01
—
3158726
TENNCARE SELECT
—
05
—
3288441
—
TN
01
—
490004734
MEDICARE RAILROAD
—
01
—
7957161
AETNA
—
01
—
8356899
CIGNA
—
Enumeration date
09/07/2006
Last updated
11/18/2010
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