National Provider Identifier Database

TYSON E GREEN, DPM – NPI #1407001787
Surgery, Foot & Ankle


Contact Information

TYSON E GREEN, DPM
1747 IMPERIAL BLVD
LAKE CHARLES, LA70605-5362
Phone: 337-721-7236
Fax: 337-721-7237
Website:
Specialty Taxonomy Code
* Surgery, Foot & Ankle 213ES0103X

* Indicates primary specialty

NPI Profile & details for TYSON E GREEN

NPI Number 1407001787
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 11/30/2008
Last updated 01/30/2017 - About 9 years ago
Sole proprietor1 No
Identifiers
  • LA License #: DPM200024
  • LA Medicaid: 1805033
Hospital affiliation n/a

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.

Reviews for TYSON E GREEN, DPM

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