MEDICARE: JOSEPH WATTS GREENE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	45850	KY
2	207X00000X	Orthopaedic Surgery Physician	45850	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000834300	OTHER	KY	ANTHEM - NOS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	151611	OTHER	KY	SIHO - NOS
4	50052927	OTHER	KY	PASPORT - NOS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356469696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH WATTS GREENE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 776351
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-6351
Country	:	US
Telephone Number	:	502-588-9490
Fax Number	:	502-272-5116

Provider Business Practice Location Address
First Line	:	3810 SPRINGHURST BLVD STE 310
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40241-6162
Country	:	US
Telephone Number	:	502-447-5633
Fax Number	:	833-974-2507

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	01/27/2021

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Directions to “ JOSEPH WATTS GREENE M.D.” Practice Location

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