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General NPI Number Information
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NPI Number | 1104025246
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Entity Type | Organization
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Legal Business Name | MICHAEL E. GREEN
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 854 LONE OAK DR
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City | GALLATIN
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State | TN
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Zip | 37066-3694
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Country | US
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Telephone | 804-212-5305
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Fax | 615-451-0139
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Provider Business Mailing Address
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Address Line | 854 LONE OAK DR
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City | GALLATIN
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State | TN
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Zip | 37066-3694
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Country | US
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Telephone | 804-212-5305
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Fax | 615-451-0139
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Authorized Official
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Title or Position | DIRECTOR
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Name | AMY BURTON
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Credential |
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Telephone | 434-661-7762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD0000025545
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License Number State | TN
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