Champagne, Glenn
Champagne, Glenn is an sole proprietor health care provider with primary practice located at Bare Hill Road Franklin Correctional Facility, Malone NY 12953. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Champagne, Glenn can be contacted via phone (518) 483-6040.Contact Information
Primary practice address
Bare Hill Road Franklin Correctional Facility
Malone NY 12953
Phone: (518) 483-6040
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 127279-1 | New York |
Profile Details
| NPI number | 1487869087 |
|---|---|
| LBN Legal business name | Champagne, Glenn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 14th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487869087 | NPPES |
| New York | MEDICAID | 00632522 |
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