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Individual

JEFFERY C MCGLOTHLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-2500
(682) 885-2510
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7347

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
H5469
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00U87Z
BCBSTX GRP PIN
TX
05
023247201
TX
01
10010109
AMERIGROUP PIN
TX
01
119063100
FIRSTCARE PIN
TX
05
120608801
TX
05
120608802
TX
01
123977
SUPERIOR PIN
TX
05
140442803
TX
01
1436086
UHC PIN
TX
01
1640340
FIRSTHEALTH PIN
TX
01
1750369203
GPR NPI NUMBER
TX
01
4397262
AETNA PIN
TX
01
87V784
BCBSTX IND PIN
TX
01
9360939
CIGNA PIN
TX
Enumeration date
09/14/2006
Last updated
04/02/2012
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