Provider Demographics
NPI:1225532120
Name:ROBERT GREER DO, LLC
Entity Type:Organization
Organization Name:ROBERT GREER DO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALBRIGHT
Authorized Official - Last Name:GREER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:251-656-3305
Mailing Address - Street 1:5345 FARNSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-4604
Mailing Address - Country:US
Mailing Address - Phone:251-656-3305
Mailing Address - Fax:
Practice Address - Street 1:5345 FARNSWORTH DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-4604
Practice Address - Country:US
Practice Address - Phone:251-656-3305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center