Green, Charles R

Green, Charles R is an individual health care provider with primary practice located at 612 N Andover Rd , Andover KS 67002-9778. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Green, Charles R can be contacted via phone (316) 733-6618.

Contact Information

Primary practice address
612 N Andover Rd Andover KS 67002-9778
Phone: (316) 733-6618
Fax: (316) 733-5299
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 30255 Kansas

Profile Details

NPI number 1568499267
LBN Legal business name Green, Charles R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Mar 31st, 2016 - about 9 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1568499267 NPPES
Other 103199 MEDICARE
MEDICAID 100641000A MEDICARE

Popular Providers