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General NPI Number Information
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NPI Number | 1982883468
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Entity Type | Individual
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Provider Name | MARCELLA JUNE GREENE MD
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Gender | Female
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 10/15/2013
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Provider Practice Location Address
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Address Line | 7557A DANNAHER DR, SUITE 110
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City | POWELL
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State | TN
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Zip | 37849
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Country | US
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Telephone | 865-938-8121
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Fax | 865-212-5561
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Provider Business Mailing Address
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Address Line | PO BOX 52948
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City | KNOXVILLE
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State | TN
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Zip | 37950-2948
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Country | US
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Telephone | 865-306-5675
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Fax | 865-584-7712
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | TN MD47192
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License Number State | TN
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