Horace L Green
Adolescent Medicine
1420 W 43rd Ave
Pine Bluff
, Arkansas 71603-7010
Horace L Green
Adolescent Medicine
1420 W 43rd Ave
Pine Bluff
, Arkansas 71603-7010
(870) 534-8620
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Horace L Green
- 1420 W 43rd Ave
- Pine Bluff, AR
- Zip : 71603-7010
- Fax : (870) 534-8620
- Phone : (870) 534-6210
Second Address
- Horace L Green
- 1420 W 43rd Ave
- Pine Bluff, AR
- Zip : 71603-7010
- Fax : (870) 534-8620
- Phone : (870) 534-6210
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Where is Horace L Green ’s practice located?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | C4284 | AR |
National Provider Identifier
| NPI | 1093779324 |
|---|---|
| Provider Name | Horace L Green |
| First Address | Pine Bluff, AR 71603-7010 |
| Second Address | Pine Bluff, AR 71603-7010 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/04/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| D04584 | (02) | AR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.