JOHNNY BERT GREEN MD - NPI 1386612414 - Colon & Rectal Surgery in Boise, ID

Q: What is Johnny Green's NPI number?

The NPI number for Johnny Green is 1386612414. It was assigned to this individual provider in the NPPES registry on March 14, 2006.

Q: What is Johnny Green's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Q: When was this NPI record last updated?

The NPPES record for Johnny Green was last updated on November 15, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Johnny Bert Green Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JOHNNY BERT GREEN MD (NPI 1386612414) is an individual colon & rectal surgery provider in Boise, Idaho, licensed in Idaho (M-11186) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1386612414

Entity TypeIndividualMale

Primary Taxonomy208C00000X

Provider Legal NameJOHNNY BERT GREENCredential: MD

Location Address1072 N LIBERTY STREET, SUITE 201Boise, ID 83704

Mailing Address3340 E Goldstone WayMeridian, ID 83642-1026 · (208) 302-2400 · Fax (208) 302-2455

Phone(208) 302-2400

Fax(208) 302-2455

Sole ProprietorNo

Enumeration DateMarch 14, 2006

Last NPPES UpdateNovember 15, 2016

✔ NPI 1386612414 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208C00000X

Licenses✔ Licensed in ID · M-11186✔ Licensed in WA · 35113

Definition

A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.

Also ListedSurgeryTaxonomy 208600000X · License 35113 (WA)

1072 N LIBERTY STREET, Boise, ID 83704

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