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NPI Code Detail

MEDICARE: DR. JOE STEPHEN GREENE M.D.

MEDICARE:  DR. JOE STEPHEN 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
1207QA0505XAdult Medicine Physician01024876IN
2207QA0505XAdult Medicine Physician65405GA

General Provider Information

NPI Number : 1922056969
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOE STEPHEN GREENE M.D.
Provider Business Mailing Address
First Line : 1111 GLYNCO PKWY
Second Line : SUITE 200
City : BRUNSWICK
State : GA
Zip : 31525-7921
Country : US
Telephone Number : 912-261-2355
Fax Number : 912-265-5119
Provider Business Practice Location Address
First Line : 1111 GLYNCO PKWY
Second Line : SUITE 200
City : BRUNSWICK
State : GA
Zip : 31525-7921
Country : US
Telephone Number : 912-261-2355
Fax Number : 912-265-5119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 01/03/2011

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Directions to “ DR. JOE STEPHEN GREENE M.D.” Practice Location

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