Individual
DR. GLENN D MCCLENDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2425 DAVE WARD DR STE 1, CONWAY, AR 72034-8686
(501) 504-2737
(501) 499-9890
Mailing address
2425 DAVE WARD DR STE 1, CONWAY, AR 72034-8686
(501) 504-2737
(501) 499-9890
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
140
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127342717
—
AR
01
—
15710000001
QUALCHOICE
AR
01
—
5S956
BCBS
AR
01
—
P0025174
RR MEDICARE
AR
Enumeration date
08/31/2005
Last updated
10/07/2020
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