Glenn, John A
Glenn, John A is an individual health care provider with primary practice located at 840 Professional Center Dr , Eastman GA 31023-6734. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Glenn, John A can be contacted via phone (478) 374-1310.Contact Information
Primary practice address
840 Professional Center Dr
Eastman GA 31023-6734
Phone: (478) 374-1310
Fax: (478) 374-0302
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 038495 | Georgia |
Profile Details
| NPI number | 1194765420 |
|---|---|
| LBN Legal business name | Glenn, John A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | Sep 7th, 2011 - about 14 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 | 1194765420 | NPPES |
| Georgia | MEDICAID | 000613874J |
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