Green, Gordon Martin

Green, Gordon Martin is an individual health care provider with primary practice located at 295 Commonwealth Blvd W , Martinsville VA 24112-1820. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Green, Gordon Martin can be contacted via phone (276) 638-2311.

Contact Information

Primary practice address
295 Commonwealth Blvd W Martinsville VA 24112-1820
Phone: (276) 638-2311
Fax: (276) 638-3537
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101052580 Virginia

Profile Details

NPI number 1295796951
LBN Legal business name Green, Gordon Martin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Aug 21st, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295796951 NPPES
Virginia MEDICAID 010362661

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