Green, Thomas J

Green, Thomas J is an individual health care provider with primary practice located at 303 N Clyde Morris Blvd , Daytona Beach FL 32114. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Green, Thomas J can be contacted via phone (386) 254-4139.

Contact Information

Primary practice address
303 N Clyde Morris Blvd Daytona Beach FL 32114
Phone: (386) 254-4139
Fax: (386) 258-8265
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X ME0021283 Florida

Profile Details

NPI number 1861452120
LBN Legal business name Green, Thomas J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Jun 30th, 2010 - about 16 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 1861452120 NPPES
Florida MEDICAID 069212300

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