Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | C6031 | AR |
NPI | 1003878422 |
---|---|
Provider Name | James Stuart Greene |
First Address | Oklahoma City, OK 73134-1785 |
Second Address | Fort Smith, AR 72901-4921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2006 |
Last Update Date | 10/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100259740B | (05) | OK |
101906001 | (05) | AR |
C68407 | (02) | AR |