Green, Kelly Douglas

Green, Kelly Douglas is an individual health care provider with primary practice located at 2900 Hawkins Dr , Searcy AR 72143-4802. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurological Surgery. Allopathic & Osteopathic Physicians / Neurological Surgery is his primary health care specialty. Green, Kelly Douglas can be contacted via phone (501) 278-2800.

Contact Information

Primary practice address
2900 Hawkins Dr Searcy AR 72143-4802
Phone: (501) 278-2800
Fax: (501) 278-3073
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 2002010422 Missouri
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X E-9196 Arkansas

Profile Details

NPI number 1912050980
LBN Legal business name Green, Kelly Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2007
Last updated Jan 8th, 2021 - about 3 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 1912050980 NPPES
Other 1159308 CAQH

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