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General NPI Number Information
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NPI Number | 1629050059
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Entity Type | Individual
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Provider Name | BRIAN D GREENE MD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 11/08/2010
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Provider Practice Location Address
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Address Line | 171 TOWN CENTER DR
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City | ANNISTON
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State | AL
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Zip | 36205-4101
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Country | US
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Telephone | 256-237-1624
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Fax | 256-241-2277
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Provider Business Mailing Address
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Address Line | PO BOX 5430
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City | ANNISTON
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State | AL
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Zip | 36205-0430
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Country | US
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Telephone | 256-237-1624
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Fax | 256-241-2277
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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 | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | BG086607
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 30509
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License Number State | AL
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