Individual
JEFFREY W GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7945 WOLF RIVER BLVD, GERMANTOWN, TN 38138-1762
(901) 683-0055
(901) 685-2969
Mailing address
7714 POPLAR AVE STE 200, GERMANTOWN, TN 38138-3941
(901) 683-0055
(901) 685-2969
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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