Individual
MARK E GREEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1771 MADISON ST, CLARKSVILLE, TN 37043-4990
(931) 552-6622
Mailing address
1000 RIVER RD, SUITE 100, CONSHOHOCKEN, PA 19428-2439
(800) 355-3818
(610) 834-2862
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
17438
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3886218
—
TN
Enumeration date
06/05/2006
Last updated
07/08/2007
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