MEDICARE: ROBERT WILBUR GREENE JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	019597	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	135549	OTHER	TN	BLUECROSSBLUESHIELD TN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134127665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT WILBUR GREENE JR. M.D.

Provider Business Mailing Address
First Line	:	6005 PARK AVE STE 804
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-5218
Country	:	US
Telephone Number	:	901-761-5885
Fax Number	:	901-761-5398

Provider Business Practice Location Address
First Line	:	6005 PARK AVE STE 804
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-5218
Country	:	US
Telephone Number	:	901-761-5885
Fax Number	:	901-761-5398

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	12/10/2025

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