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Individual

DR. JOHN A GLENN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
840 PROFESSIONAL CENTER DR, EASTMAN, GA 31023-6734
(478) 374-1310
(478) 374-0302
Mailing address
840 PROFESSIONAL CENTER DR, EASTMAN, GA 31023-6734
(478) 374-1310
(478) 374-0302

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
038495
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000613874J
GA
Enumeration date
06/07/2006
Last updated
09/07/2011
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