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Individual
DR. GLENN D MCCLENDON
Active
Individual
DR. GLENN D MCCLENDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
140
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127342717
—
AR
01
—
15710000001
QUALCHOICE
AR
01
—
5S956
BCBS
AR
01
—
P0025174
RR MEDICARE
AR
Enumeration date
08/31/2005
Last updated
10/07/2020
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