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J DOUGLAS GREEN JR MD PA NPI 1417072190


NPI Information

NPI: 1417072190
Provider Name: J DOUGLAS GREEN JR MD PA

Doing Business As: JACKSONVILLE HEARING & BALANCE INSTITUTE

Classification: Otolaryngology - 207YX0901X
Entity Type: Organization

Specialization: Otology & Neurotology

Address:
10475 CENTURION PKWY N
SUITE 303
JACKSONVILLE, FL
ZIP 32256
Phone: (904) 399-0350
Get Directions

J DOUGLAS GREEN JR MD PA is an otology and neurotology otolaryngology in Jacksonville, FL. The provider is an otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone. J DOUGLAS GREEN JR MD PA NPI is 1417072190. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Jacksonville Hearing & Balance Institute.

The provider's business location address is:

10475 CENTURION PKWY N
SUITE 303
JACKSONVILLE, FL
ZIP 32256
Phone: (904) 399-0350
Fax: (904) 399-5914

The provider's authorized official is J Douglas Green .
The authorized official title is Otolaryngologist and has the following contact phone number (904) 399-0350.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 8/23/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207YX0901XOtolaryngologyOtology & NeurotologyME0058964FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E75228MEDICARE UPINFLORIDA
212134MEDICARE ID-TYPE UNSPECIFIEDFLORIDA
3371813100FLMEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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