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Organization
DR GLENN C STOW PLLC
Active
Organization
DR GLENN C STOW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN C STOW MD (PHYSICIAN)
(405) 273-0313
Entity
Organization
Contact information
Practice address
2304 N HARRISON ST, SHAWNEE, OK 74804-3135
(405) 273-0313
Mailing address
PO BOX 268988, OKLAHOMA CITY, OK 73126-8988
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20824
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100101260E
—
OK
Enumeration date
10/30/2007
Last updated
05/01/2012
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