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1538136148
DIANE ELAINE GREEN
JACKSON, TN
NPI
1538136148
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: TN 13431)
Enumeration Date
2006-03-02
Last Update Date
2009-07-17
Business Address
-- DIANE ELAINE GREEN MD
708 W FOREST AVE
JACKSON, TN 38301-3901
Phone number: 731-660-8759
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Mailing Address
-- DIANE ELAINE GREEN MD
1804 HIGHWAY 45 BYP SUITE 604
JACKSON, TN 38305-4436
Phone number: 731-660-8759
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