Individual
MRS. REGINIQUE L GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5366 MENDENHALL MALL, MEMPHIS, TN 38115-4505
(901) 701-2500
Mailing address
2595 CENTRAL AVE, MEMPHIS, TN 38104-5905
(901) 260-8500
(901) 260-8598
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35-74642
OH
207Q00000X
Family Medicine Physician
Primary
48371
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104967
—
OH
Enumeration date
09/25/2006
Last updated
03/17/2018
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