Individual
DR. BENERANDA SOPHIA FORD-GLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 W LINCOLN ST STE 201, BELLEVILLE, IL 62220-1901
(618) 641-5803
(618) 641-5813
Mailing address
301 WEST LINCOLN STREET, SUITE 201, BELLEVILLE, IL 62220
(618) 641-5803
(618) 641-5813
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036119047
IL
Other
Enumeration date
05/30/2007
Last updated
08/23/2017
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