Glenn, Jerry
Glenn, Jerry is an individual health care provider with primary practice located at 3901 S Atherton St Suite 2, State College PA 16801-8324. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgical Oncology, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgical Oncology is his primary health care specialty. Glenn, Jerry can be contacted via phone (814) 466-2300.Contact Information
Primary practice address
3901 S Atherton St Suite 2
State College PA 16801-8324
Phone: (814) 466-2300
Fax: (814) 466-2822
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgical Oncology | 2086X0206X | MD030666E | Pennsylvania |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD030666E | Pennsylvania |
Profile Details
| NPI number | 1750345229 |
|---|---|
| LBN Legal business name | Glenn, Jerry |
| Credentials | M.D., PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1750345229 | NPPES |
| Pennsylvania | Other | 30477 | GEISINGER HEALTH PLAN |
| Pennsylvania | Other | 50047400 | GEISINGER HEALTH PLAN |
| Pennsylvania | MEDICAID | 0009667720004 | GEISINGER HEALTH PLAN |
| Pennsylvania | Other | GL116265 | GEISINGER HEALTH PLAN |
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