Individual
JACQUELINE LYNN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
930 FRANKLIN ST SE, HUNTSVILLE, AL 35801-4312
(256) 533-3388
(256) 801-6905
Mailing address
930 FRANKLIN ST SE, HUNTSVILLE, AL 35801-4312
(256) 533-3388
(256) 801-6905
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
067886
GA
207RI0011X
Interventional Cardiology Physician
067886
GA
207RI0011X
Interventional Cardiology Physician
Primary
37971
AL
Other
Enumeration date
04/18/2009
Last updated
08/19/2019
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