Green, Adam W.
Green, Adam W. is an individual health care provider with primary practice located at 3101 Se 14Th St , Bentonville AR 72712-4900. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Green, Adam W. can be contacted via phone (479) 986-6199.Contact Information
Primary practice address
3101 Se 14Th St
Bentonville AR 72712-4900
Phone: (479) 986-6199
Fax: (479) 636-0371
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | E-8330 | Arkansas |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | E-8330 | Arkansas |
Profile Details
| NPI number | 1861620213 |
|---|---|
| LBN Legal business name | Green, Adam W. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2009 |
| Last updated | Dec 4th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861620213 | NPPES |
| Arkansas | Other | P01507946 | RR MEDICARE |
| Arkansas | MEDICAID | 204518001 | RR MEDICARE |
| Arkansas | MEDICAID | 1861620213 | RR MEDICARE |
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