Individual
DR. WILLIAM MICHAEL GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7850
Mailing address
797 N COACHMAN LN, SPANISH FORK, UT 84660-6357
(801) 592-6317
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
011521
AZ
207L00000X
Anesthesiology Physician
Primary
13314945-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2019
Last updated
03/17/2025
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