Green, Jeffrey W

Green, Jeffrey W is an individual health care provider with primary practice located at 7945 Wolf River Blvd , Germantown TN 38138-1762. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Green, Jeffrey W can be contacted via phone (901) 683-0055.

Contact Information

Primary practice address
7945 Wolf River Blvd Germantown TN 38138-1762
Phone: (901) 683-0055
Fax: (901) 685-2969
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD029757 Tennessee

Profile Details

NPI number 1922046200
LBN Legal business name Green, Jeffrey W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated May 21st, 2020 - 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 1922046200 NPPES
Mississippi MEDICAID 00126459
Mississippi MEDICAID 205887201
Mississippi MEDICAID Q014089
Mississippi MEDICAID 145117001
Mississippi Other T13426A
Mississippi Other 1A7288

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