Search › Idaho › 208C00000X
Johnny Green, MD
NPI 1386612414 · on the registry since 2006
Practice
- Address
- 1072 N Liberty Street
Suite 201
Boise, ID 83704 - Phone
- (208) 302-2400
- Fax
- (208) 302-2455
- Organisation at this address
- Bryan J Anderson Md Pc
Shauna T Williams Md Pa
Treasure Valley Colon & Rectal Clinic PllcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 81
Registry record
- Primary taxonomy
- 208C00000X
208C00000X
- Also registered as
- 208600000X
208C00000X - Licence states on file
- WA, ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-11-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho