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Contact Information

GARY H GREENE, OD
3450 N GLASSFORD HILL RD STE E
PRESCOTT VALLEY, AZ86314-1351
 Phone: 928-499-3152
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Corneal and Contact Management

152WC0802X 41 Optometry
Indicates primary specialty

NPI Profile & details for GARY H GREENE · (Male)

NPI # 1568454155
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 08/18/2005
Last updated 01/28/2026 - About 4 months ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # AZ0810
  • AZ Medicaid 137085
  • AZ Other 088458 AHCCCS
  • AZ Other AZ0179560 BLUE CROSS BLUE SHIELD
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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