Provider Demographics
NPI:1659306090
Name:GREER, CARLTON RUSS (MD/NEUROSURGEON)
Entity Type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:RUSS
Last Name:GREER
Suffix:
Gender:M
Credentials:MD/NEUROSURGEON
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Mailing Address - Street 1:PO BOX 3123
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71210-3123
Mailing Address - Country:US
Mailing Address - Phone:318-323-9433
Mailing Address - Fax:318-361-2680
Practice Address - Street 1:414 WOOD ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7445
Practice Address - Country:US
Practice Address - Phone:318-323-9433
Practice Address - Fax:318-361-2680
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA010638207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1312002Medicaid
LA1312002Medicaid
LA5J102Medicare ID - Type UnspecifiedCARLTON RUSS GREER, M.D.