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General NPI Number Information
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NPI Number | 1356469696
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Entity Type | Individual
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Provider Name | JOSEPH WATTS GREENE M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 3810 SPRINGHURST BLVD STE 310
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City | LOUISVILLE
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State | KY
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Zip | 40241-6162
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Country | US
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Telephone | 502-447-5633
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Fax | 833-974-2507
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 45850
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 45850
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License Number State | KY
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