Dr. Johnny Richard Green Jr., DO
Internal Medicine in Oxford, MS. Individual provider (NPI-1).
NPI number1851979983
StatusActive
Last updated in NPPESMar 14, 2025
Details
- NPI
- 1851979983
- Entity type
- Individual (NPI-1)
- Name
- Dr. Johnny Richard Green Jr.
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 30, 2021
- Certification date
- Mar 14, 2025
- Last updated
- Mar 14, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - INTERNAL MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- 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 |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 33279 | MS | Yes |
| 207R00000X | Internal Medicine | T-4329 | TN | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
81 Ed Perry Blvd Ste 107Oxford, MS 38655-3465
Phone 662-636-5290
Mailing address
965 Ridge Lake BlvdMemphis, TN 38120-9401
Phone 901-227-4692
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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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