Green, Stephen Tyler
Green, Stephen Tyler is an individual health care provider with primary practice located at 1111 Medical Center Blvd Ste N707 , Marrero LA 70072-3158. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Green, Stephen Tyler can be contacted via phone (504) 934-8550.Contact Information
Primary practice address
1111 Medical Center Blvd Ste N707
Marrero LA 70072-3158
Phone: (504) 934-8550
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 327285 | Louisiana |
Profile Details
| NPI number | 1285970830 |
|---|---|
| LBN Legal business name | Green, Stephen Tyler |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2012 |
| Last updated | Apr 20th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285970830 | NPPES |
| Louisiana | MEDICAID | 2412914 |
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