Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 45850 | KY |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 45850 | KY |
NPI | 1356469696 |
---|---|
Provider Name | Joseph Watts Greene |
First Address | Chicago, IL 60677-6351 |
Second Address | Louisville, KY 40241-6162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 27/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000834300 | ANTHEM - NOS (01) | KY |
151611 | SIHO - NOS (01) | KY |
201201590 | (05) | IN |
50052927 | PASPORT - NOS (01) | KY |
7100131720 | (05) | KY |