Provider Demographics
NPI:1821104514
Name:GREENE, HAMP HUNTER III (MD)
Entity Type:Individual
Prefix:
First Name:HAMP
Middle Name:HUNTER
Last Name:GREENE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-273-4159
Mailing Address - Fax:334-273-4290
Practice Address - Street 1:2065 E SOUTH BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2458
Practice Address - Country:US
Practice Address - Phone:334-747-7250
Practice Address - Fax:334-747-7270
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL68662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL165807Medicaid
AL511-14061OtherBCBS OF AL
AL000002450Medicaid
AL102I137144OtherMEDICARE
AL165807Medicaid
AL165807Medicaid