Doctor Name: | DR. BURDGE F GREEN |
NPI Number: | 1689969602 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 300 Werner Hot Springs, AR - 719136406 |
Business Phone Number: | 5016221043 |
Business Fax Number: | 5016221199 |
Mailing Address: | Po Box 21850, HOT SPRINGS |
State: | AR |
Postal Code: | 719031850 |
Phone Number: | 8709042807 |
Fax Number: | 5013214057 |
NPI Enumeration Date: | 06/17/2011 |
NPI Last Update Date: | 01/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |