Provider Demographics
NPI:1437393956
Name:GREEN, JOHN GUY III (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:GUY
Last Name:GREEN
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:859 FRANKLIN SPRINGS ST
Mailing Address - Street 2:
Mailing Address - City:ROYSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30662-3931
Mailing Address - Country:US
Mailing Address - Phone:706-245-8595
Mailing Address - Fax:770-536-7858
Practice Address - Street 1:3640 MUNDY MILL RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-4152
Practice Address - Country:US
Practice Address - Phone:770-532-9111
Practice Address - Fax:770-536-7858
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA013183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist