Organization
BOWLING GREEN ORTHOPAEDICS INC.
Active
Organization
BOWLING GREEN ORTHOPAEDICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MERRILL GLADDEN MD (PRESIDENT)
(419) 352-1519
Entity
Organization
Contact information
Practice address
1215 RIDGEWOOD DR STE A, BOWLING GREEN, OH 43402-2694
(419) 352-1519
(419) 352-7004
Mailing address
1215 RIDGEWOOD DR STE A, BOWLING GREEN, OH 43402-2694
(419) 352-1519
(419) 352-7004
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0495012
—
OH
01
—
10677
CHAMPUS GROUP ID#
OH
Enumeration date
09/27/2006
Last updated
04/25/2019
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