Gordon F Green (NPI# 1659341519, PAC ID# 4385732338) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1659341519 |
| PAC ID by PECOS | 4385732338 |
| Professional Enrollment ID | I20071108000692 |
| Full Name | Gordon F Green |
| Organization Legal Name | PHYNET INC |
| Address |
402 N Kaufman St Linden TX 75563-5234 |
| Phone Number | 9037565581 |
| Gender | M |
| Medical School | UNIVERSITY OF TEXAS MEDICAL SCHOOL AT SAN ANTONIO |
| Graduation Year | 1988 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | UROLOGY |
| Group Practice PAC ID | 8527038298 |
| Number of Group Practice Members | 14 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450801 | CHRISTUS ST MICHAEL HEALTH SYSTEM |
| 450032 | GOOD SHEPHERD MEDICAL CENTER MARSHALL |
| Address | Phone | Organization |
|---|---|---|
| 219 N Polk St, Jefferson, TX 75657-2131 | 9036652600 | PHYNET INC |
| 402 N Kaufman St, Linden, TX 75563-5234 | 9037565581 | PHYNET INC |
| Organization Legal Name | PHYNET INC |
| Physicians | 20 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lori Ann Fried | Nurse Practitioner | Phynet Inc | 3211 N 4th St A, Longview, TX 75605-5145 |
| Tessa J Barton | Nurse Practitioner | Phynet Inc | 2019 A S Henderson Blvd, Suite 4, Kilgore, TX 75662-3565 |
| Heather R Grindle | Nurse Practitioner | Phynet Inc | 307 W Upshur Ave, Gladewater, TX 75647-2121 |
| Terry H. Elders | Nurse Practitioner | Phynet Inc | 402 N Kaufman St, Linden, TX 75563-5234 |
| Tracy C Webster | Nurse Practitioner | Phynet Inc | 219 N Polk St, Jefferson, TX 75657-2131 |
| Robert C Mcdaniel | Family Medicine | Phynet Inc | 307 W Upshur Ave, Gladewater, TX 75647-2121 |
| Mary A Corley | Nurse Practitioner | Phynet Inc | 219 N Polk St, Jefferson, TX 75657-2131 |
| Cassandra L Ford | Nurse Practitioner | Phynet Inc | 3211 N 4th St A, Longview, TX 75605-5145 |
| Juan Raul Zapata | Family Medicine | Phynet Inc | 307 W Upshur Ave, Gladewater, TX 75647-2121 |
| Laura L Brown | Nurse Practitioner | Phynet Inc | 3211 N 4th St A, Longview, TX 75605-5145 |
| Street Address |
402 N KAUFMAN ST |
| City | LINDEN |
| State | TX |
| Zip | 75563-5234 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Terry H. Elders | Nurse Practitioner | Phynet Inc | 402 N Kaufman St, Linden, TX 75563-5234 |
| Trent Eugene Gale | Nurse Practitioner | Phynet Inc | 402 N Kaufman St, Linden, TX 75563-5234 |
| City | LINDEN |
| Zip Code | 75563 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | LINDEN + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Gordon F Green.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.