| Doctor Name: | DR. JAMES DOUGLAS GREEN |
| NPI Number: | 1265438493 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 58964 |
| Business Practice Address: | 10475 Centurion Pkwy N Ste 303 Jacksonville, FL - 322565003 |
| Business Phone Number: | 9043990350 |
| Business Fax Number: | 9043995914 |
| Mailing Address: | 11945 San Jose Blvd, Bldg 300 JACKSONVILLE |
| State: | FL |
| Postal Code: | 322231613 |
| Phone Number: | 9043961725 |
| Fax Number: | 9043991717 |
| NPI Enumeration Date: | 06/22/2005 |
| NPI Last Update Date: | 03/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 58964 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |