Individual
KEVIN DWIGHT GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 SOUTH BECKHAM AVE, TYLER, TX 75701
(903) 595-5101
(903) 597-2314
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G5113
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100007934
RAIL ROAD MEDICARE
TX
05
—
129618808
—
TX
05
—
129618812
—
TX
01
—
75-2616977-008
TRICARE
TX
01
—
75-2616977-054
TRICARE
TX
01
—
75-2616977-125
TRICARE
TX
01
—
8GC722
BCBS
TX
Enumeration date
08/15/2006
Last updated
01/10/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us