Individual provider · Type 1 NPI

Edward Green, MD

Diagnostic Radiology Physician · Jackson, MS

NPI number 1073719803 Active

Practice location

969 Lakeland Dr
Jackson, MS 39216-4606

Call (601) 200-6162 Map

Mailing address

PO Box 23073
Jackson, MS 39225-3073

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician 2085R0202X135313 (NC)
Diagnostic Radiology Physician Primary 2085R0202X17833 (MS)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

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About NPI 1073719803

Edward Green, MD's National Provider Identifier is 1073719803, issued on Jun 27, 2007. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Jackson, MS. The record was last updated on Oct 6, 2022.