Individual
JEFFREY W GREEN
Active
Individual
JEFFREY W GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD029757
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126459
—
MS
05
—
145117001
—
AR
01
—
1A7288
MEDICARE MS
MS
05
—
205887201
—
MO
05
—
Q014089
—
TN
01
—
T13426A
MEDICARE TN
TN
Enumeration date
06/02/2006
Last updated
05/21/2020
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