| Doctor Name: | THOMAS J GREEN |
| NPI Number: | 1942207709 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ME 86894 |
| Business Practice Address: | 1673 Mason Ave Suite 305 Daytona Beach, FL - 321175515 |
| Business Phone Number: | 3862747118 |
| Business Fax Number: | 3862746173 |
| Mailing Address: | 1673 Mason Ave, Suite 305 DAYTONA BEACH |
| State: | FL |
| Postal Code: | 321175515 |
| Phone Number: | 3862747118 |
| Fax Number: | 3862746173 |
| NPI Enumeration Date: | 07/07/2005 |
| NPI Last Update Date: | 07/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | ME 86894 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |