Green, Benny J

Green, Benny J is an individual health care provider with primary practice located at 14309 Cantrell Rd , Little Rock AR 72223-4230. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Green, Benny J can be contacted via phone (501) 224-6727.

Contact Information

Primary practice address
14309 Cantrell Rd Little Rock AR 72223-4230
Fax: (501) 224-0374
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X C6412 Arkansas

Profile Details

NPI number 1609873983
LBN Legal business name Green, Benny J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Jan 11th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609873983 NPPES
Arkansas MEDICAID 101838001
Arkansas Other 080017867

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