Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 28804 | KY |
NPI | 1013003136 |
---|---|
Provider Name | Dr. Brennan P Greene |
First Address | Louisville, KY 40206-1738 |
Second Address | Louisville, KY 40206-1738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 03/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200045010 | (05) | IN |
64288046 | (05) | KY |