Provider Demographics
NPI:1922182534
Name:GREENE, RICHARD STEPHEN (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:STEPHEN
Last Name:GREENE
Suffix:
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 1:910 WAYNE ROAD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372
Mailing Address - Country:US
Mailing Address - Phone:731-925-4405
Mailing Address - Fax:731-925-4488
Practice Address - Street 1:910 WAYNE ROAD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372
Practice Address - Country:US
Practice Address - Phone:731-925-4405
Practice Address - Fax:731-925-4488
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD11706208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery