Individual
BILLIE K GLADE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Mailing address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
026121
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000272
PREFERRED ONE
MN
01
—
1700778
MEDICA
MN
01
—
31T07GL
BLUE SHIELD
MN
01
—
763164
AMERICA'S PPO
MN
01
—
A008
CHAMPUS
MN
01
—
HP27497
HEALTH PARTNERS
MN
Enumeration date
01/23/2006
Last updated
07/08/2007
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