Individual
DAVID GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
102 LEXINGTON DRIVE, SUITE 100, MADISON, MS 39110
(601) 973-1688
Mailing address
764 LAKELAND DR FL 2, JACKSON, MS 39216-4651
(601) 984-6800
(601) 984-6811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26604
MS
Other
Enumeration date
04/21/2016
Last updated
06/28/2019
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