Green, Kevin J

Green, Kevin J is an individual health care provider with primary practice located at 2038 Monument Ave , Richmond VA 23220-2708. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Green, Kevin J can be contacted via phone (804) 353-3555.

Contact Information

Primary practice address
2038 Monument Ave Richmond VA 23220-2708
Phone: (804) 353-3555
Fax: (804) 353-9630
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0618-000057 Virginia

Profile Details

NPI number 1699770495
LBN Legal business name Green, Kevin J
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Apr 28th, 2011 - about 13 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 1699770495 NPPES
Virginia Other 012848001 DME POINT OF SERVICE
Virginia MEDICAID 89-2028-1 DME POINT OF SERVICE
Virginia Other 586486 DME POINT OF SERVICE
Virginia Other 22-00047 DME POINT OF SERVICE
Virginia Other 038113 DME POINT OF SERVICE

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