Green, Mark Ellison

Green, Mark Ellison is an individual health care provider with primary practice located at 365 Bmh Physicians Office Bldg , Maryville TN 37804-5820. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Green, Mark Ellison can be contacted via phone (865) 980-5360.

Contact Information

Primary practice address
365 Bmh Physicians Office Bldg Maryville TN 37804-5820
Phone: (865) 980-5360
Fax: (865) 980-5356
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X MD0000017438 Tennessee
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD0000017438 Tennessee

Profile Details

NPI number 1154395044
LBN Legal business name Green, Mark Ellison
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Jun 28th, 2023 - about last year

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 1154395044 NPPES
Tennessee MEDICAID 1526169

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