MEDICARE: KARL A GREENE MD

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	208600000X	Surgery Physician	43655	WI
2	207T00000X	Neurological Surgery Physician	43655	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376535492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARL A GREENE MD

Provider Business Mailing Address
First Line	:	9555 76TH ST
Second Line	:
City	:	PLEASANT PRAIRIE
State	:	WI
Zip	:	53158-1984
Country	:	US
Telephone Number	:	262-577-8000
Fax Number	:	262-577-8869

Provider Business Practice Location Address
First Line	:	9555 76TH ST
Second Line	:
City	:	PLEASANT PRAIRIE
State	:	WI
Zip	:	53158-1984
Country	:	US
Telephone Number	:	262-577-8000
Fax Number	:	262-577-8869

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	06/27/2024

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Directions to “ KARL A GREENE MD” Practice Location

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