Individual
MR. JAMES ELLIS GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
526 PEARL NIX PARKWAY, SUITE #103, GAINESVILLE, GA 30501
(770) 535-7978
(770) 535-8050
Mailing address
PO BOX 7970, GAINESVILLE, GA 30504
(770) 535-7978
(770) 535-8050
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G027200
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D0330448A
—
GA
Enumeration date
05/15/2007
Last updated
07/08/2007
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