NPI 1114966462

Justin Green

Practitioner Surgery Physician Los Alamos, NM

Practice location

Address: 3917 West Rd STE a, Los Alamos, NM 87544-2292
Phone: (505) 661-8900
Mailing address: 3917 West Rd, Los Alamos, NM 87544-2275

Registered specialties

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 4568 (SD)

Other Surgery providers in New Mexico →

Registry record

NPI: 1114966462
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Jun 2006
Record last updated: 27 Sep 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.