Individual
DR. RICHARD LEE GLAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2401 VILLAGE PROFESSIONAL DRIVE, OPELIKA, AL 36801-4702
(334) 749-8121
(334) 749-6166
Mailing address
2401 VILLAGE PROFESSIONAL DRIVE, OPELIKA, AL 36801-4702
(334) 749-8121
(334) 749-6166
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
26042
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26042
ALABAMA MEDICAL LICENSE
AL
01
—
515-22766
BCBS AL PROV # OPELIKA
AL
01
—
515-22780
BCBS AL PROV # AUBURN
AL
01
—
969760
AAP ID
—
Enumeration date
02/13/2007
Last updated
03/07/2023
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