Individual
PAUL V MCGLYNN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
49TH MEDICAL GROUP/SGOPF, 280 FIRST STREET, BLDG 23, HOLLOMAN AFB, NM 88330-8273
(575) 572-7091
(575) 572-2259
Mailing address
49TH MEDICAL GROUP/SGOPF, 280 FIRST STREET, BLDG 23, HOLLOMAN AFB, NM 88330-8273
(575) 572-7091
(575) 572-2259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002538
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002134B
—
GA
01
—
11529519
CAQH
GA
Enumeration date
04/24/2007
Last updated
04/09/2018
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