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Individual

DR. GARY S GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
9302 N MERIDIAN ST, SUITE 150, INDIANAPOLIS, IN 46260-1873
(317) 848-4444
(317) 848-7976
Mailing address
9302 N MERIDIAN ST, SUITE 150, INDIANAPOLIS, IN 46260-1873
(317) 848-4444
(317) 848-7976

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001443A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000089981
ANTHEM
Enumeration date
11/08/2005
Last updated
07/18/2007
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