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
Phone: (386) 274-7118
Fax: (386) 274-6173
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | ME 86894 | Florida |
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME86894 | Florida |
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | ME86894 | Florida |
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | ME 86894 | Florida |
Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | ME 86894 | Florida |
Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | ME 86894 | Florida |
Allopathic & Osteopathic Physicians / Therapeutic Radiology | 2085R0203X | ME 86894 | Florida |
Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | ME 86894 | Florida |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1942207709 | NPPES |
Florida | Other | 79205 | BCBS OF FLORIDA |
Florida | MEDICAID | 267313400 | BCBS OF FLORIDA |
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