Green, Jerril
Green, Jerril is an sole proprietor health care provider with primary practice located at 14319 Saint Michael Dr , Little Rock AR 72211-5572. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as his primary health care specialty. Green, Jerril can be contacted via phone (501) 590-2885.Contact Information
Primary practice address
14319 Saint Michael Dr
Little Rock AR 72211-5572
Phone: (501) 590-2885
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | E-1961 | Arkansas |
Profile Details
| NPI number | 1457441016 |
|---|---|
| LBN Legal business name | Green, Jerril |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 13th, 2006 |
| Last updated | Nov 12th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457441016 | NPPES |
| Arkansas | MEDICAID | 135223001 |
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