Green, Bryan Robert

Green, Bryan Robert is an individual health care provider with primary practice located at 2016 S Main St , Maryville MO 64468-2655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Green, Bryan Robert can be contacted via phone (660) 562-7999.

Contact Information

Primary practice address
2016 S Main St Maryville MO 64468-2655
Phone: (660) 562-7999
Fax: (660) 562-7996
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2005034471 Missouri

Profile Details

NPI number 1295791366
LBN Legal business name Green, Bryan Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jul 18th, 2024 - about 4 months 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 1295791366 NPPES
Iowa MEDICAID 1295791366
Iowa Other 49561031
Iowa MEDICAID 1295791366
Iowa MEDICAID 201084370A
Iowa Other 1295791366
Iowa Other P00273140

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