Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. TYSON ELLIS GREEN, D.P.M.
ActiveDR. TYSON ELLIS GREEN, D.P.M. is a Foot & Ankle Surgery Podiatrist healthcare provider located in LAKE CHARLES, Louisiana. NPI 1407001787 is currently active in the NPPES registry. Verify at CMS.
Foot & Ankle Surgery Podiatrist · LAKE CHARLES, LA
Registration Details
- NPI Number
- 1407001787
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 30, 2008 (17.680376627058 yrs)
- Last Updated
- Jan 30, 2017
- License
-
DPM200024 (LA)
Practice Information
- Address
-
1747 IMPERIAL BLVDLAKE CHARLES, LA, 706055362Browse LA providers · Browse ZIP 70605
- Phone
- 3377217236
- Fax
- 3377217237
- Primary Specialty
-
Foot & Ankle Surgery Podiatrist
213ES0103X
Other Foot & Ankle Surgery Podiatrist Providers in LAKE CHARLES, LA
| Name | Credential | NPI |
|---|---|---|
| VERNON L GARBER | DPM | 1043218449 |
| DR. JOHN KALIEB POURCIAU | D.P.M. | 1053589580 |
| DR. MALLORY MICHELLE PRZYBYLSKI | DPM | 1437449915 |
| DR. DANIEL THOMAS HALL IV | DPM | 1891124665 |
| CHRISTINE CAMILLE PALMA | DPM | 1932696754 |
| BRADLEY LANE JIMERSON | DPM | 1013579150 |
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.