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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JOHNNY BERT GREEN, MD

Active

JOHNNY BERT GREEN, MD is a Colon & Rectal Surgery healthcare provider located in BOISE, Idaho. NPI 1386612414 is currently active in the NPPES registry. Verify at CMS.

Colon & Rectal Surgery · BOISE, ID

Registration Details

NPI Number
1386612414
Provider Type
Individual
Gender
Male
NPI Issued
Mar 14, 2006 (20.435386104593 yrs)
Last Updated
Nov 15, 2016
Licenses
35113 (WA)
35113 (WA)
M-11186 (ID)

Practice Information

Address
1072 N LIBERTY STREET
SUITE 201
BOISE, ID, 83704
Browse ID providers · Browse ZIP 83704
Phone
2083022400
Fax
2083022455
Primary Specialty
Colon & Rectal Surgery
208C00000X
Additional Specialty
Colon & Rectal Surgery
Additional Specialty
Colon & Rectal Surgery

Other Colon & Rectal Surgery Providers in BOISE, ID

Name Credential NPI
DR. J. CHRIS CHRISTOPHER KANTARIAN MD 1699774042
MR. JAMES A OLSON MD 1912992249
SHAUNA WILLIAMS M.D. 1821150285
ANTHONY DINALLO 1205193760
MS. ERIN FENNERN 1295175008
SHEEV INDRAVADAN DATTANI MD 1760903363
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.