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Contact Information

KIRBY A GREEN, MD
2290 SOUTH 1300 EAST
MEDICAL MARTS
SALT LAKE CITY, UT84106-2831
 Phone: 801-474-0800
 Fax: 810-467-1126
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KIRBY A GREEN · (Male)

NPI Number 1619909744
Status Active
Credentials MD
Entity Individual
Enumeration date 07/07/2006
Last updated 11/07/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 014738
  • UT License # 6053966-1205
  • LA Medicaid 1194841
  • UT Medicaid 200785958001
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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