Green, Thomas J

Green, Thomas J is an individual health care provider with primary practice located at 1673 Mason Ave Suite 305, Daytona Beach FL 32117-5515. He recently has 8 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Therapeutic Radiology, Allopathic & Osteopathic Physicians / Neuroradiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Green, Thomas J can be contacted via phone (386) 274-7118.

Contact Information

Primary practice address
1673 Mason Ave Suite 305 Daytona Beach FL 32117-5515
Fax: (386) 274-6173
Website:

Profile Details

NPI number 1942207709
LBN Legal business name Green, Thomas J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Sep 21st, 2016 - about 8 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 1942207709 NPPES
Florida Other 79205 BCBS OF FLORIDA
Florida MEDICAID 267313400 BCBS OF FLORIDA

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