TYSON E GREEN, DPM, Surgery, Foot & Ankle LAKE CHARLES, LA

Contact Information

TYSON E GREEN, DPM

1747 IMPERIAL BLVD
LAKE CHARLES, LA 70605-5362

Phone: 337-721-7236
Fax: 337-721-7237
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Surgery, Foot & Ankle	213ES0103X	48	Podiatry

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NPI Profile & details for TYSON E GREEN · (Male)

NPI #	`1407001787`
Status	Active
Credentials	DPM (Doctor of Podiatric Medicine)
Entity	Individual
Enumeration date	11/30/2008
Last updated	01/30/2017 - About 9 years ago
Sole proprietor ¹	No
Identifiers	LA License # DPM200024 LA Medicaid 1805033
Hospital affiliation(s)	CHRISTUS ST PATRICK HOSPITAL - (Acute Care) 524 DR MICHAEL DEBAKEY STREET LAKE CHARLES, LA 70601 JENNINGS AMERICAN LEGION HOSPITAL - (Acute Care) 1634 ELTON ROAD JENNINGS, LA 70546 WEST CALCASIEU CAMERON HOSPITAL - (Acute Care) 701 EAST CYPRESS STREET SULPHUR, LA 70663

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

Contact Information

Specialty

Surgery, Foot & Ankle

NPI Profile & details for TYSON E GREEN · (Male)

Reviews for TYSON E GREEN

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