Green, Robert L.

Green, Robert L. is an individual health care provider with primary practice located at 2501 N Patterson St , Valdosta GA 31602-1735. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Green, Robert L. can be contacted via phone (229) 433-1000.

Contact Information

Primary practice address
2501 N Patterson St Valdosta GA 31602-1735
Phone: (229) 433-1000
Fax: (706) 596-6723
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0101042362 Virginia
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 82121 Georgia
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 082121 Georgia

Profile Details

NPI number 1558386706
LBN Legal business name Green, Robert L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Oct 22nd, 2020 - about 6 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 1558386706 NPPES
Georgia MEDICAID 003218661A
Georgia MEDICAID 7251505
Georgia MEDICAID 7206941

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