Dr Johnny Richard Green Jr, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Oxford, Mississippi. His current practice location is
81 Ed Perry Blvd Ste 107, Oxford, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(662) 636-5290.
Dr Johnny Richard Green Jr is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1851979983.
Physician's Profile
Full Name | Dr Johnny Richard Green Jr |
---|
Gender | Male |
---|
Speciality | Student In An Organized Health Care Education/training Program |
---|
Location | 81 Ed Perry Blvd Ste 107, Oxford, Mississippi |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1851979983
- Provider Enumeration Date: 03/30/2021
- Last Update Date: 01/24/2024
Medicare PECOS Information:
- PECOS PAC ID: 2567853823
- Enrollment ID: I20211221000072
Medical Identifiers
Medical identifiers for Dr Johnny Richard Green Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1851979983 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | T-4329 (Tennessee) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Johnny Richard Green Jr is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Johnny Richard Green Jr, DO 965 Ridge Lake Blvd, Memphis, TN 38120-9401 Ph: (901) 227-4692 | Dr Johnny Richard Green Jr, DO 81 Ed Perry Blvd Ste 107, Oxford, MS 38655-3465 Ph: (662) 636-5290 |
Reviews and Comments