Healthcare Provider Details

I. General information

NPI: 1639136849
Provider Name (Legal Business Name): DARRIN GREEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 S 4TH ST
MONTROSE CO
81401-4222
US

IV. Provider business mailing address

2754 COMPASS DR STE 377
GRAND JUNCTION CO
81506-8723
US

V. Phone/Fax

Practice location:
  • Phone: 970-240-7734
  • Fax: 970-240-7263
Mailing address:
  • Phone: 970-241-2212
  • Fax: 970-257-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39984
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: