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General NPI Number Information
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NPI Number | 1720292063
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Entity Type | Individual
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Provider Name | JEFFREY EDWARD GREENWOOD MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 1000 MEDICAL CENTER BLVD
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7694
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Country | US
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Telephone | 678-312-3317
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Fax |
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Provider Business Mailing Address
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Address Line | 5273 ALDEBURGH DR
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City | SUWANEE
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State | GA
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Zip | 30024-7563
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Country | US
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Telephone |
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 060842
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 69271
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License Number State | TN
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