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NPI 1780780379

NPI 1780780379 : YVONNE M GREENE M.D. : DUBLIN, GA

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General NPI Number Information
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    NPI Number           |    1780780379
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    Entity Type          |    Individual 
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    Provider Name        |    YVONNE M GREENE M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/15/2006
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    Last Update Date     |    06/04/2021
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Provider Practice Location Address
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    Address Line         |    1826 VETERANS BLVD 
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    City                 |    DUBLIN
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    State                |    GA
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    Zip                  |    31021-3620
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    Country              |    US
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    Telephone            |    478-272-1210
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    745 GRANT ST SE 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30315-1463
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    Country              |    US
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    Telephone            |    404-216-9502
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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        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    46416
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    License Number State |    GA
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