DR. Kenneth O Green, M.D,

NPI #1780680900 in Belleville, Illinois

Provider Information

NPI Number: 1780680900
Entity Type: Individual
Name: DR. Kenneth O Green, M.D,
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Ophthalmology
Credential: M.D,
Enumeration Date: Jun 22, 2005
Last Updated: Apr 13, 2009

Practice Location

Address: 111 W LINCOLN ST
City: Belleville
State: Illinois
ZIP Code: 62220-2019
Phone: (618) 234-1774

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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