Individual
MR. GLEN A JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1700 E PARKS HWY, SUITE 200, WASILLA, AK 99654-7352
(907) 373-6055
(907) 373-6077
Mailing address
1700 E PARKS HWY, SUITE 200, WASILLA, AK 99654-7352
(907) 373-6055
(907) 373-6077
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
303
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
303
ALASKA STATE LICENSE NUMBER
AK
Enumeration date
08/04/2008
Last updated
06/23/2009
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