MEDICARE: ELTON BENJAMIN 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	2085R0202X	Diagnostic Radiology Physician	MD0000049025	TN
2	2085N0700X	Neuroradiology Physician	49025	TN

General Provider Information

NPI Number	:	1649471780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELTON BENJAMIN GREENE M.D.

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:	615-936-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-2523
Country	:	US
Telephone Number	:	615-322-3000
Fax Number	:

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

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	03/31/2022

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