Individual
JESSICA YVONNE MCCLINTOCK GLOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1025 MICHIGAN AVE, LOGANSPORT, IN 46947-1593
(574) 722-3566
Mailing address
1025 MICHIGAN AVE, LOGANSPORT, IN 46947-1593
(574) 722-3566
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01073034A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000830960
ANTHEM
IN
05
—
201178870
—
IN
Enumeration date
06/25/2009
Last updated
06/11/2019
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