Provider Demographics
NPI:1811134729
Name:GREENE, PEYTON CHRISTOPHER (DO)
Entity type:Individual
Prefix:
First Name:PEYTON
Middle Name:CHRISTOPHER
Last Name:GREENE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N 20TH ST STE 6
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5454
Mailing Address - Country:US
Mailing Address - Phone:334-749-3385
Mailing Address - Fax:334-705-3431
Practice Address - Street 1:121 N 20TH ST STE 6
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5454
Practice Address - Country:US
Practice Address - Phone:334-749-3385
Practice Address - Fax:334-705-3431
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.1053207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine