Individual provider · Type 1 NPI

Johnny Bert Green, MD

Colon & Rectal Surgery Physician · Boise, ID

NPI number 1386612414 Active

Practice location

1072 N Liberty Street, Suite 201
Boise, ID 83704

Call (208) 302-2400 Map

Fax (208) 302-2455

Mailing address

3340 E Goldstone Way
Meridian, ID 83642-1026

Specialties and licenses

TaxonomyCodeLicense
Surgery Physician 208600000X35113 (WA)
Colon & Rectal Surgery Physician 208C00000X35113 (WA)
Colon & Rectal Surgery Physician Primary 208C00000XM-11186 (ID)

Colon & Rectal Surgery Physician: A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.

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About NPI 1386612414

Johnny Bert Green, MD's National Provider Identifier is 1386612414, issued on Mar 14, 2006. The primary taxonomy on file is Colon & Rectal Surgery Physician (208C00000X), and the practice location is in Boise, ID. The record was last updated on Nov 15, 2016.