Provider Demographics
NPI:1861670416
Name:GREENVIEW SPECIALTY ASSOCIATES LLC
Entity Type:Organization
Organization Name:GREENVIEW SPECIALTY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-886-4969
Mailing Address - Street 1:1325 ANDREA ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-5852
Mailing Address - Country:US
Mailing Address - Phone:270-393-9663
Mailing Address - Fax:270-393-9664
Practice Address - Street 1:1325 ANDREA ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-5852
Practice Address - Country:US
Practice Address - Phone:270-393-9663
Practice Address - Fax:270-393-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00594Medicare PIN