Green, Jimmy W
Green, Jimmy W is an individual health care provider with primary practice located at 600 Gresham Dr , Norfolk VA 23507-1904. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Forensic Pathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Green, Jimmy W can be contacted via phone (757) 388-3221.Contact Information
Primary practice address
600 Gresham Dr
Norfolk VA 23507-1904
Phone: (757) 388-3221
Fax: (757) 388-3799
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Forensic Pathology | 207ZF0201X | 026285 | Georgia |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 0101-241204 | Virginia |
Profile Details
| NPI number | 1174503494 |
|---|---|
| LBN Legal business name | Green, Jimmy W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2006 |
| Last updated | Dec 22nd, 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 | 1174503494 | NPPES |
| Virginia | MEDICAID | 1174503494 | |
| Virginia | Other | P00396483 |
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