Individual
DR. ROAN JAMISON GLOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
990 SOUTH AVE, STE 210, ROCHESTER, NY 14620-2763
(585) 341-9541
(585) 341-9550
Mailing address
601 ELMWOOD AVE, BOX 652, ROCHESTER, NY 14642-0001
(585) 341-9541
(585) 341-9550
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
274719
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03921208
—
NY
Enumeration date
05/30/2007
Last updated
04/28/2023
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