Individual
DR. G GLEN CHITWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2710 RIFE MEDICAL LANE, ROGERS, AR 72758-1452
(479) 338-8000
(501) 664-0302
Mailing address
DEPT 241 PO BOX 1559, TULSA, OK 74101-1559
(877) 243-8418
(918) 663-2281
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C-5273
AR
2085R0202X
Diagnostic Radiology Physician
C5273
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118166001
—
AR
Enumeration date
04/18/2006
Last updated
03/30/2012
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