Healthcare Provider Details

I. General information

NPI: 1194942151
Provider Name (Legal Business Name): CLAYTON BARON GREEN M.D.,PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF COLORADO SCHOOL OF MEDICINE 4900 E. 9TH AVE
DENVER CO
80262-0001
US

IV. Provider business mailing address

UNIVERSITY OF COLORADO SCHOOL OF MEDICINE 4900 E. 9TH AVE
DENVER CO
80262-0001
US

V. Phone/Fax

Practice location:
  • Phone: 303-315-7424
  • Fax:
Mailing address:
  • Phone: 303-315-7424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2226
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number303395
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number54350
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: