Greene, Gary Howard
Greene, Gary Howard is an sole proprietor health care provider with primary practice located at 4201 N 16Th St Ste 160 , Phoenix AZ 85016-5348. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Greene, Gary Howard can be contacted via phone (602) 277-5007.Contact Information
Primary practice address
4201 N 16Th St Ste 160
Phoenix AZ 85016-5348
Phone: (602) 277-5007
Fax: (480) 505-0922
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | AZ0810 | Arizona |
| Eye and Vision Services Providers / Optometrist | 152W00000X | AZ0810 | Arizona |
Profile Details
| NPI number | 1568454155 |
|---|---|
| LBN Legal business name | Greene, Gary Howard |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 18th, 2005 |
| Last updated | Jan 20th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568454155 | NPPES |
| Arizona | Other | AZ0179560 | BLUE CROSS BLUE SHIELD |
| Arizona | Other | P00276390 | BLUE CROSS BLUE SHIELD |
| Arizona | Other | 137085 | BLUE CROSS BLUE SHIELD |
| Arizona | MEDICAID | 137085 | BLUE CROSS BLUE SHIELD |
| Arizona | Other | AZ0810 | BLUE CROSS BLUE SHIELD |
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