Individual
DR. PAUL RAY GLANVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
21945 HIGHWAY 550, RIDGWAY, CO 81432-9660
(970) 626-5255
Mailing address
21945 HIGHWAY 550, RIDGWAY, CO 81432-9660
(970) 626-5255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11814-020
WI
207Q00000X
Family Medicine Physician
29762
WA
207Q00000X
Family Medicine Physician
Primary
45104
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06437058
—
MS
Enumeration date
07/16/2006
Last updated
07/08/2007
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