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NPI Code Detail

MEDICARE: CURTIS GREEN D.O.

MEDICARE: CURTIS GREEN D.O.
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
12086S0129XVascular Surgery Physician036-095245IL
2208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician036-095245IL
3208600000XSurgery Physician036-095245IL

General Provider Information

NPI Number : 1386750685
Entity Type Code : Individual
Provider Name (Legal Business Name) : CURTIS GREEN D.O.
Provider Business Mailing Address
First Line : PO BOX 372
Second Line :
City : MATTOON
State : IL
Zip : 61938-0372
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1000 HEALTH CENTER DR STE 401
Second Line :
City : MATTOON
State : IL
Zip : 61938-4648
Country : US
Telephone Number : 217-258-4020
Fax Number : 217-258-4023
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 01/09/2025

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Directions to “ CURTIS GREEN D.O.” Practice Location

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