Glenn, Stephen B

Glenn, Stephen B is an individual health care provider with primary practice located at 2600 Saint Michael Dr , Texarkana TX 75503-5220. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Glenn, Stephen B can be contacted via phone (903) 614-5111.

Contact Information

Primary practice address
2600 Saint Michael Dr Texarkana TX 75503-5220
Phone: (903) 614-5111
Fax: (903) 614-5114
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X F5920 Texas
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X F5920 Texas
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X R3803 Arkansas

Profile Details

NPI number 1336149434
LBN Legal business name Glenn, Stephen B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2005
Last updated Apr 23rd, 2024 - about 8 months 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 1336149434 NPPES
Arkansas MEDICAID 114425001
Arkansas MEDICAID 116232302
Arkansas Other 8AN228
Arkansas Other P00830978
Arkansas MEDICAID 116232304
Arkansas MEDICAID 100167150A

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