Individual
DR. JACK J 'BUDDY' GLISSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 E LOCUST ST, DRESDEN, TN 38225-1467
(731) 364-3196
(731) 364-5359
Mailing address
130 E LOCUST ST, DRESDEN, TN 38225-1467
(731) 364-3196
(731) 364-5359
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21707
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3065945
—
TN
Enumeration date
10/05/2005
Last updated
07/08/2007
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