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Individual

JAMES MICHAEL GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(850) 420-6566
Mailing address
2338 COUNTY HIGHWAY 280 E, DEFUNIAK SPRINGS, FL 32435-5623
(850) 420-6566

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME63572
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18895
BCBS
FL
01
3525756
CIGNA
FL
01
5681078
AETNA
FL
Enumeration date
06/08/2005
Last updated
03/06/2024
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