Kevin Dwight Green in Tyler - Gastroenterology
Kevin Dwight Green - NPI 1811900194
Kevin Dwight Green is a Gastroenterology in Tyler, Texas. Kevin Dwight Green practices all healthcare services and medical treatments related to Gastroenterology. The NPI Number for Kevin Dwight Green is 1811900194. The last update date is 2017-01-10.
Kevin Dwight Green's current location address is 1720 South Beckham Ave, Tyler, Texas. You can contact this provider via phone number 9035955101 and fax number 9035972314. The mailing address for Kevin Dwight Green is 1720 South Beckham Ave, Tyler, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin Dwight Green |
|---|---|
| Address | 1720 South Beckham Ave, Tyler, Texas |
| Phone Number | 9035955101 |
| Fax Number | 9035972314 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1811900194 |
|---|---|
| Provider Enumeration Date | 2006-08-15 |
| Last Updated Date | 2017-01-10 |
Provider Mailing Address Detail
| Address | 1720 South Beckham Ave |
|---|---|
| City | Tyler |
| State | Texas (TX) |
| Post Code | 75701 |
| Phone Number | 9035955101 |
| Fax Number | 9035972314 |
Provider's Primary Taxonomy Detail
| Speciality | Gastroenterology |
|---|---|
| Taxonomy | 207Rg0100X |
| Licence No | G5113 |
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Definition: An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and perf |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 75-2616977-008 | TX | TRICARE | |
| 129618812 | TX | -- | |
| 75-2616977-125 | TX | TRICARE | |
| 129618808 | TX | -- | |
| 75-2616977-054 | TX | TRICARE | |
| 100007934 | TX | RAIL ROAD MEDICARE | |
| 8GC722 | TX | BCBS |
Post Comment/ Review Below
What is the unique identification code assigned to Kevin Dwight Green by the Centers for Medicare & Medicaid Services?
The Kevin Dwight Green has been issued the NPI (National Provider Identifier) 1811900194. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Kevin Dwight Green is physically located?
The Kevin Dwight Green is physically situated at the following address: 1720 South Beckham Ave, Tyler, TX, 75701.
What is Kevin Dwight Green's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Kevin Dwight Green's specialized field of practice is Gastroenterology, and the corresponding taxonomy code that categorizes this area of specialization is 207Rg0100X.
On what date did the Centers for Medicare & Medicaid Services assign the 1811900194 to Kevin Dwight Green?
The Centers for Medicare & Medicaid Services assigned the 1811900194 to Kevin Dwight Green on 2006-08-15.
As of what date were the Kevin Dwight Green's details last updated?
The information pertaining to the Kevin Dwight Green, including its address, specialty, and other details, was most recently updated on 2017-01-10.