Provider Demographics
NPI:1922056969
Name:GREENE, JOE STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:STEPHEN
Last Name:GREENE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1111 GLYNCO PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-7921
Mailing Address - Country:US
Mailing Address - Phone:912-261-2355
Mailing Address - Fax:912-265-5119
Practice Address - Street 1:1111 GLYNCO PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-7921
Practice Address - Country:US
Practice Address - Phone:912-261-2355
Practice Address - Fax:912-265-5119
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-01-03
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Provider Licenses
StateLicense IDTaxonomies
IN01024876207QA0505X
GA65405207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine