Johnny Bert Green, MD
Johnny Bert Green, MD is a Surgery Physician in Boise, Idaho. Licensed in Idaho and Washington. Registered with an NPI since 2006.
- Licensed in
- ID, WA
- In the registry since
- 2006
- Specialties on file
- 3
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
1072 N Liberty St Ste 201Boise, ID 83704
Phone: (208) 302-2400
Fax: (208) 302-2455
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Colon & Rectal Surgery Physician (primary) | Taxonomy 208C00000X · Licence M-11186 (ID) |
|---|---|
| Surgery Physician | Taxonomy 208600000X · Licence 35113 (WA) |
| Colon & Rectal Surgery Physician | Taxonomy 208C00000X · Licence 35113 (WA) |
Record details
| NPI number | 1386612414 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | March 14, 2006 |
| Last updated in NPPES | November 15, 2016 |
| Mailing address | 3340 E Goldstone Way, Meridian, ID 83642-1026 |
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Frank J Fazzio Jr., MD
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Matthew Hatch
999 N Curtis Rd Ste 415, Boise, ID 83706-1334 · (208) 302-2600
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Rachel Elizabeth Heneghan, MD
333 N 1st St Ste 280, Boise, ID 83702-6132 · (208) 345-6545
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Dr. Ciara Rosemary Huntington, MD
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