| Doctor Name: | DR. KIMBERLY J GREEN |
| NPI Number: | 1720174873 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O |
| License Number: | 2002456A |
| Business Practice Address: | 1090 Cambridge Sq Suite A Alpharetta, GA - 300091875 |
| Business Phone Number: | 7707549880 |
| Business Fax Number: | 7707549881 |
| Mailing Address: | 1090 Cambridge Sq, Suite A ALPHARETTA |
| State: | GA |
| Postal Code: | 300091875 |
| Phone Number: | 7707549880 |
| Fax Number: | 7707549881 |
| NPI Enumeration Date: | 10/05/2006 |
| NPI Last Update Date: | 07/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 2002456A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |