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General NPI Number Information
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NPI Number | 1144667924
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Entity Type | Individual
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Provider Name | DONALD WAYNE GREEN DVM
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Gender | Male
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Dates
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Enumeration Date | 06/03/2013
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Last Update Date | 06/03/2013
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Provider Practice Location Address
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Address Line | 805 S DIXIE HWY
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City | MUNFORDVILLE
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State | KY
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Zip | 42765-9203
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Country | US
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Telephone | 270-524-0301
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Fax | 270-524-1145
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Provider Business Mailing Address
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Address Line | 805 S DIXIE HWY
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City | MUNFORDVILLE
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State | KY
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Zip | 42765-9203
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Country | US
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Telephone | 270-524-0301
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Fax | 270-524-1145
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | NS-KY-1398
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License Number State | KY
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