Gleason, Terrence Patrick

Gleason, Terrence Patrick is an individual health care provider with primary practice located at 1810 Mesquite Ave , Lake Havasu City AZ 86403-5886. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Gleason, Terrence Patrick can be contacted via phone (928) 855-8515.

Contact Information

Primary practice address
1810 Mesquite Ave Lake Havasu City AZ 86403-5886
Phone: (928) 855-8515
Fax: (928) 854-6206
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 24347 Arizona
Other Service Providers / Specialist 174400000X MD00031165 Washington

Profile Details

NPI number 1740263953
LBN Legal business name Gleason, Terrence Patrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated Mar 30th, 2016 - about 8 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 1740263953 NPPES
Arizona MEDICAID 351271
Arizona Other 340012308
Arizona Other AZ0395470

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