| Green Primary Care | |
|
2004 Airport Rd Sw Ste 212 Huntsville AL 35801-5848 | |
| (256) 784-7336 | |
| Not Available |
| Full Name | Green Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 2004 Airport Rd Sw Ste 212, Huntsville, Alabama |
| Authorized Official Name and Position | Tyler Green (PRINCIPAL) |
| Authorized Official Contact | 2566514685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Primary Care 2004 Airport Rd Sw Ste 212 Huntsville AL 35801-5848 Ph: (256) 784-7336 | Green Primary Care 2004 Airport Rd Sw Ste 212 Huntsville AL 35801-5848 Ph: (256) 784-7336 |
| NPI Number | 1518439918 |
|---|---|
| Provider Enumeration Date | 12/23/2018 |
| Last Update Date | 01/19/2020 |
| Medicare PECOS PAC ID | 2264760073 |
|---|---|
| Medicare Enrollment ID | O20190816003173 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518439918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Christopher M O'barr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023493509 PECOS PAC ID: 3476856055 Enrollment ID: I20160115000494 |
| Provider Name | Tyler R Green |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417390543 PECOS PAC ID: 5395030829 Enrollment ID: I20190819003809 |
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