Diane Elaine Green, MD
Pathology, Anatomic Pathology & Clinical Pathology in Jackson, TN. Individual provider (NPI-1).
NPI number1538136148
StatusActive
Last updated in NPPESJul 17, 2009
Details
- NPI
- 1538136148
- Entity type
- Individual (NPI-1)
- Name
- Diane Elaine Green
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 2, 2006
- Last updated
- Jul 17, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | 13431 | TN | Yes |
Practice location
708 W Forest AveJackson, TN 38301-3901
Phone 731-660-8759
Mailing address
1804 Highway 45 BypSuite 604
Jackson, TN 38305-4436
Phone 731-660-8759
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 10 Anatomic Pathology & Clinical Pathology Physician providers in Jackson · All 3,212 providers in Jackson
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