Individual
MR. JASON CLARK GLADDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ALC
Contact information
Practice address
4110 HIGHWAY 31 SOUTH, DECATUR, AL 35601
(256) 260-1691
(256) 341-0747
Mailing address
1316 SOMERVILLE RD SE, SUITE 1, DECATUR, AL 35601-4305
(256) 260-7361
(256) 341-0747
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C2377A
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051078129
BCBS OF AL PROVIDER #
AL
Enumeration date
11/24/2006
Last updated
09/15/2015
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