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Individual

JAMIE DENISE WOODS GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1277 WELLBROOK CIR NE STE B, CONYERS, GA 30012-3973
(770) 922-5745
(678) 750-1406
Mailing address
1277 WELLBROOK CIR NE STE B, CONYERS, GA 30012-3973
(770) 922-5745
(678) 750-1406

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
083197
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003180139B
GA
Enumeration date
03/28/2016
Last updated
02/03/2020
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