Individual
DR. PHILLIP C GLAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
101 US HIGHWAY 31 N, ATHENS, AL 35611-2142
(256) 230-2799
(256) 230-2839
Mailing address
101 US HIGHWAY 31 N, ATHENS, AL 35611-2142
(256) 230-2799
(256) 230-2839
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10271
AL
183500000X
Pharmacist
8719
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10271
PHARMACIST LICENSE
AL
01
—
8719
PHARMACIST LICENSE
TN
Enumeration date
08/25/2011
Last updated
08/25/2011
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