Green-Mack, Thelma Lynette

Green-Mack, Thelma Lynette is an individual health care provider with primary practice located at 3850 Shore Drive Suiote 305, Indianapolis IN 46254-5621. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is her primary health care specialty. Green-Mack, Thelma Lynette can be contacted via phone (317) 920-3220.

Contact Information

Primary practice address
3850 Shore Drive Suiote 305 Indianapolis IN 46254-5621
Phone: (317) 920-3220
Fax: (317) 920-3221
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 01037601B Indiana
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 01037601 Indiana
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 01037601 Indiana

Profile Details

NPI number 1841358017
LBN Legal business name Green-Mack, Thelma Lynette
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2006
Last updated Mar 9th, 2023 - about 2 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 1841358017 NPPES
Indiana MEDICAID 100130200
Indiana Other 250010985
Indiana Other 000000092241
Indiana Other 1841358017

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