Mr Wallace Maxwell Green, PAC in Fayetteville, GA - Psychiatry & Neurology

Mr Wallace Maxwell Green, PAC is a Psychiatry & Neurology - Neurology physician based in Fayetteville, Georgia. Mr Wallace Maxwell Green is licensed to practice in Georgia (license number 001827) and his current practice location is 1275 Highway 54 W, Ste.105, Fayetteville, Georgia. He can be reached at his office (for appointments etc.) via phone at (770) 719-2965.

NPI number for Mr Wallace Maxwell Green is 1306979059 and his current mailing address is 1275 Highway 54 W, Ste.105, Fayetteville, Georgia. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1306979059.

Contact Information

	Mr Wallace Maxwell Green, PAC
	1275 Highway 54 W, Ste.105, Fayetteville, GA 30214-4549
	(770) 719-2965
	(770) 719-2963

Physician's Profile

Full Name	Mr Wallace Maxwell Green
Gender	Male
Speciality	Psychiatry & Neurology - Neurology
Location	1275 Highway 54 W, Fayetteville, Georgia
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1306979059
Provider Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Mr Wallace Maxwell Green such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1306979059	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2084N0400X	Psychiatry & Neurology - Neurology	001827 (Georgia)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Wallace Maxwell Green is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Wallace Maxwell Green, PAC 1275 Highway 54 W, Ste.105, Fayetteville, GA 30214-4549 Ph: (770) 719-2965	Mr Wallace Maxwell Green, PAC 1275 Highway 54 W, Ste.105, Fayetteville, GA 30214-4549 Ph: (770) 719-2965

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Psychiatry & Neurology Doctors in Fayetteville, GA

Evan Mccarroll Johnson, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1265 Highway 54 W Ste 500d, Fayetteville, GA 30214 Phone: 770-506-5410
Gary Bruce Lebendiger, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 115 Habersham Dr, Fayetteville, GA 30214 Phone: 770-461-9944 Fax: 770-461-9779
Shaw Wendi Fortuchang, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 110 N Park Dr, Fayetteville, GA 30214 Phone: 770-376-6726 Fax: 770-376-6727
Dr. Olufemi Abiodun Taiwo, M.D Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 110 Braxton Ct, Fayetteville, GA 30214 Phone: 678-610-7100 Fax: 678-610-7111
Dr. Ana Maria Cuebas, M.D Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 715 Bradley Dr, Fayetteville, GA 30214 Phone: 770-358-5252
Mr. Virendra V Ranadive, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 115 Sumner Rd Fl 2, Fayetteville, GA 30214 Phone: 770-716-1562 Fax: 770-716-0145

Mr Wallace Maxwell Green, PAC - Psychiatry & Neurology in Fayetteville, GA