Chitwood, G Glen

Chitwood, G Glen is an individual health care provider with primary practice located at 2710 Rife Medical Lane , Rogers AR 72758-1452. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Chitwood, G Glen can be contacted via phone (479) 338-8000.

Contact Information

Primary practice address
2710 Rife Medical Lane Rogers AR 72758-1452
Phone: (479) 338-8000
Fax: (501) 664-0302
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X C5273 Arkansas
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X C-5273 Arkansas

Profile Details

NPI number 1164487864
LBN Legal business name Chitwood, G Glen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Mar 30th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164487864 NPPES
Arkansas MEDICAID 118166001

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