# JAMES E. GLEASON JR, MDPC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013198050
- **Authorized official:** JAMES E GLEASON JR. MD (MD)
- **Authorized official phone:** (770) 994-6969

## Contact information

- **Practice address:** 33 UPPER RIVERDALE RD SW STE 118, RIVERDALE, GA 30274-2642
- **Practice address phone:** (770) 994-6969
- **Practice address fax:** (888) 651-5324
- **Mailing address:** PO BOX 962466, RIVERDALE, GA 30296-6923
- **Mailing address phone:** (678) 361-8091
- **Mailing address fax:** (888) 651-5324

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 030466 | GA | Yes |

## Other

- **Enumeration date:** 11/19/2007
- **Last updated:** 01/17/2024