Koester, Glenn Alan

Koester, Glenn Alan is an individual health care provider with primary practice located at 3863 S. Boulevard , Edmond OK 73034. He recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as his primary health care specialty. Koester, Glenn Alan can be contacted via phone (405) 216-5444.

Contact Information

Primary practice address
3863 S. Boulevard Edmond OK 73034
Fax: (405) 216-5445
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 18783 Oklahoma

Profile Details

NPI number 1790892461
LBN Legal business name Koester, Glenn Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2006
Last updated Jul 19th, 2013 - about 11 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 1790892461 NPPES
Oklahoma MEDICAID 100152170B

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