Provider Demographics
NPI:1407896541
Name:GREEN, RICHARD FRANCIS (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FRANCIS
Last Name:GREEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2780
Mailing Address - Country:US
Mailing Address - Phone:717-757-6780
Mailing Address - Fax:717-757-4640
Practice Address - Street 1:3949 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2780
Practice Address - Country:US
Practice Address - Phone:717-757-6780
Practice Address - Fax:717-757-4640
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003245L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA199473OtherKEYSTONE
PAA99473OtherAMERIHEALTH
PA1854396OtherHIGHMARK GROUP#
PA2995500OtherCIGNA
PA350024038OtherPALMETTO GBA, RAILROAD MEDICARE
PA199473OtherHIGHMARK BLUE SHIELD
PA232597218OtherTAX ID #
PA2715506000OtherINDEPENDENCE BC GROUP#
PAU07734OtherUPIN
PA0069195000OtherINDEPENDENCE BC PIN#
PA02652700OtherCAPITOL BLUE CROSS
PA2123237OtherMAMSI
PA415969OtherHEALTHAMERICA HEALTHASSURANCE
PA350024038OtherPALMETTO GBA, RAILROAD MEDICARE
PA350024038OtherPALMETTO GBA, RAILROAD MEDICARE