Provider Demographics
NPI:1053526988
Name:GREEN, CHRISTOPHER JASON (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JASON
Last Name:GREEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4537
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL263752085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL207191Medicaid
AL208132Medicaid
AL210771Medicaid
AL242937Medicaid
AL206630Medicaid
AL212581Medicaid
AL242945Medicaid
AL243048Medicaid
AL206204Medicaid
AL207227Medicaid
AL211682Medicaid
AL240032Medicaid
AL243011Medicaid
AL206203Medicaid
AL211589Medicaid
AL206460Medicaid
AL207190Medicaid
AL219458Medicaid
AL227661Medicaid
AL239084Medicaid
AL244242Medicaid
AL206632Medicaid
AL207774Medicaid
AL211594Medicaid
AL228189Medicaid