Green, Brian A

Green, Brian A is an individual health care provider with primary practice located at 1661 International Place Drive Suite 350, Memphis TN 38120. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Pediatric Radiology is his primary health care specialty. Green, Brian A can be contacted via phone (901) 685-2696.

Contact Information

Primary practice address
1661 International Place Drive Suite 350 Memphis TN 38120
Phone: (901) 685-2696
Fax: (901) 682-9747
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Radiology 2085P0229X MD0000046433 Tennessee
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 2004005488 Missouri

Profile Details

NPI number 1033143714
LBN Legal business name Green, Brian A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Aug 11th, 2010 - about 14 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 1033143714 NPPES
Missouri Other 127217 BLUE CHOICE
Missouri Other 751786 BLUE CHOICE
Missouri MEDICAID 201269206 BLUE CHOICE

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