| James W Greene Md Llc | |
|
3215 Shrine Rd Ste 3 Brunswick GA 31520-4300 | |
| (912) 434-9164 | |
| (912) 434-9386 |
| Full Name | James W Greene Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3215 Shrine Rd Ste 3, Brunswick, Georgia |
| Authorized Official Name and Position | James Walter Greene (PRESIDENT) |
| Authorized Official Contact | 9124349164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James W Greene Md Llc 1015 Arthur J Moore Dr # 2 Saint Simons Is GA 31522-2206 Ph: (912) 434-9164 | James W Greene Md Llc 3215 Shrine Rd Ste 3 Brunswick GA 31520-4300 Ph: (912) 434-9164 |
| NPI Number | 1396165577 |
|---|---|
| Provider Enumeration Date | 04/25/2014 |
| Last Update Date | 07/08/2022 |
| Medicare PECOS PAC ID | 3476779828 |
|---|---|
| Medicare Enrollment ID | O20140722000378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396165577 | NPI | - | NPPES |
| 202G702594 | Other | GA | MEDICARE GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 029657 (Georgia) | Primary |
| Provider Name | James W Greene |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144315326 PECOS PAC ID: 4486692688 Enrollment ID: I20050419000779 |
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