Individual
DR. GLEN R BAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
690 N COFCO CENTER CT, STE 290, PHOENIX, AZ 85008-6474
(602) 631-3161
(602) 631-3162
Mailing address
PO BOX 29870, PHOENIX, AZ 85038-9870
(602) 772-3800
(602) 772-3801
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
8968
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204488
—
AZ
01
—
3Z3921
HEALTHNET
AZ
Enumeration date
05/11/2006
Last updated
11/21/2011
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