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Mr. Wallace Maxwell Green, PAC
Neurology Physician in Fayetteville, Georgia
NPI 1306979059

Wallace Maxwell Green is a Neurology Physician based in Fayetteville, GA and is specialized in Neurology. Wallace Maxwell Green practices in Fayetteville, GA and has the professional credentials of PAC. The NPI Number for Wallace Maxwell Green is 1306979059 and holds a License No. 001827 (Georgia).

The current practice location address for Wallace Maxwell Green is 1275 Highway 54 W, Fayetteville, GA and can be reached out via phone at 770-719-2965 and via fax at 770-719-2963.

Location: 1275 Highway 54 W, Fayetteville, GA, 30214-4549
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306979059
Provider Name
Wallace Maxwell Green
Credential
PAC
Provider Entity Type
Individual
Gender
Male
Address
1275 Highway 54 W, Fayetteville, GA, 30214-4549
Phone Number
770-719-2965
Fax Number
770-719-2963
Provider Enumeration Date
03/13/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1275 Highway 54 W
City
Fayetteville
State
Georgia
Zip
30214-4549
Phone Number
770-719-2965
Fax Number
770-719-2963
person
Provider Business Mailing Address Details
Address
1275 Highway 54 W
City
Fayetteville
State
Georgia
Zip
30214-4549
Phone Number
770-719-2965
Fax Number
770-719-2963
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Neurology
Taxonomy
2084N0400X
License No.
001827 (Georgia)
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
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