J Douglas Green Jr MD PA

Primary specialty

Otology & Neurotology PhysicianTaxonomy code 207YX0901X

License

ME0058964 Issued in FL

Legal business name

J DOUGLAS GREEN JR MD PA

Doing business as

Jacksonville Hearing & Balance Institute

Practice address

10475 Centurion Pkwy N
Suite 303
Jacksonville, FL 32256

Phone

(904) 399-0350

Fax

(904) 399-5914

NPI assigned

Mar 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. J Douglas Green Jr., M.D.

Title

Otolaryngologist

Phone

(904) 399-0350

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jacksonville Hearing & Balance Institute Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187827200000",
    "number": "1417072190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10475 CENTURION PKWY N",
            "address_2": "SUITE 303",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-399-0350",
            "fax_number": "904-399-5914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10475 CENTURION PKWY N",
            "address_2": "SUITE 303",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-399-0350",
            "fax_number": "904-399-5914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J DOUGLAS GREEN JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-08-23",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OTOLARYNGOLOGIST",
        "authorized_official_telephone_number": "904-399-0350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "FL",
            "license": "ME0058964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371813100FL",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Hearing & Balance Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vanessa Izquierdo, APRN
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• J. C. Home Care Inc
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• Otology & Neurotology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Otology & Neurotology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.