NPI age
19 years
Enumerated 2007-03-13
● Active
Type 1 · Individual
MR. Wallace Maxwell Green, PAC
Green is 1 of 11 psychiatry & neurology providers in Fayetteville and 1 of 681 in Georgia.
Primary specialty
Psychiatry & Neurology
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2007-07-08
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 681 active psychiatry & neurology providers in Georgia.
NPI age
19 years
↑ 2 yr above median (17 yr)
State licenses
1 state
18% of peers hold multiple states
Subspecialties
0
35% of peers hold subspecialties
NPI lifetime · 2007 → 2026
2007-03Enumerated in NPPES
2007
2026
Where they practice
Practice location
1275 Highway 54 W, Ste.105
Fayetteville, GA 302144549
Mailing address
1275 Highway 54 W, Ste.105
Fayetteville, GA 302144549
Specialties
-
Psychiatry & Neurology PrimaryA 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.
Practice context
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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