Green, Phillip Edward

Green, Phillip Edward is an individual health care provider with primary practice located at 3087 Professional Plz , Germantown TN 38138-7912. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Green, Phillip Edward can be contacted via phone (901) 761-0800.

Contact Information

Primary practice address
3087 Professional Plz Germantown TN 38138-7912
Phone: (901) 761-0800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 17865 Tennessee

Profile Details

NPI number 1639175037
LBN Legal business name Green, Phillip Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Apr 16th, 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 1639175037 NPPES
Mississippi MEDICAID 00015638
Mississippi MEDICAID 3026653
Mississippi MEDICAID 105352001

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