Individual
JASON GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 W MAPLE ST, FARMINGTON, NM 87401-6113
(505) 609-6349
(505) 609-6348
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD2021-0302
NM
Other
Enumeration date
04/03/2015
Last updated
11/12/2024
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