Individual
BRIAN A GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1109 BURLEYSON RD, SUITE 205, DALTON, GA 30720-3094
(706) 428-3822
(706) 428-3864
Mailing address
1109 BURLEYSON RD STE 205, DALTON, GA 30720-3094
(706) 428-3822
(706) 428-3864
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
032911
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52255730001
BLUE CROSS/BLUE SHIELD
GA
Enumeration date
10/05/2005
Last updated
07/08/2007
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