FREDERICK GREENE SR. PA

SOUTHCENTRAL FOUNDATION

Dr FREDERICK GREENE SR. PA is a male medical professional, specializing in Physician Assistant. He graduated in 1981.

Contact

SOUTHCENTRAL FOUNDATION

101 AIRPORT RD
ILIAMNA
AK
99606

Tel: 9075711818

FREDERICK GREENE SR. PA Information

Npi 1639241110
Pac Id 6608825617
Professional Enrollment Id I20081208000760
Last Name GREENE
First Name FREDERICK
Middle Name
Suffix SR.
Gender M
Credential PA
Medical School Name OTHER
Graduation Year 1981
Primary Specialty PHYSICIAN ASSISTANT
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name SOUTHCENTRAL FOUNDATION
Group Practice Pac Id 5496663627
Number Of Group Practice Members 127
Line 1 Street Address 101 AIRPORT RD
Line 2 Street Address
Marker Of Address Line 2 Suppression
City ILIAMNA
State AK
Zip Code 99606
Phone Number 9075711818
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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