Individual
CHRISTOPHER SCOTT GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2705 N LEBANON ST STE 300, LEBANON, IN 46052
(765) 485-8649
(765) 485-8650
Mailing address
2605 N LEBANON ST, LEBANON, IN 46052-1476
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01080947A
IN
208000000X
Pediatrics Physician
01080947A
IN
208D00000X
General Practice Physician
Primary
01080947A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201292650
—
IN
Enumeration date
05/18/2015
Last updated
10/11/2023
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