Individual
CARNELL GREEN JR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
567 N 5TH ST, TERRE HAUTE, IN 47809-1903
(812) 237-3632
Mailing address
805 GRANITE LN, CONWAY, AR 72034-3513
(501) 580-6676
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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