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General NPI Number Information
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NPI Number | 1669486973
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Entity Type | Organization
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Legal Business Name | DRS. GREEN, P.C.
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 1 MEDICAL PARK BLVD SUITE 450W
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City | BRISTOL
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State | TN
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Zip | 37620-7430
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Country | US
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Telephone | 423-968-3713
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Fax | 423-968-7352
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Provider Business Mailing Address
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Address Line | 1 MEDICAL PARK BLVD SUITE 450W
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City | BRISTOL
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State | TN
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Zip | 37620-7430
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Country | US
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Telephone | 423-968-3713
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Fax | 423-968-7352
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. DONNA T. OSTERMEYER
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Credential |
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Telephone | 423-764-1084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 034106
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 015559
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 011243
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 038379
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 023958
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 009980
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License Number State | TN
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