Green, James Douglas

Green, James Douglas is an individual health care provider with primary practice located at 750 N Broadway , Peru IN 46970-1027. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Green, James Douglas can be contacted via phone (765) 472-8907.

Contact Information

Primary practice address
750 N Broadway Peru IN 46970-1027
Phone: (765) 472-8907
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 02001778A Indiana

Profile Details

NPI number 1841273083
LBN Legal business name Green, James Douglas
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated Sep 8th, 2021 - about 5 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 1841273083 NPPES
Indiana MEDICAID 200087340

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