Individual
DR. BRANDY NICOLE GLASCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
(573) 634-7423
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
(573) 634-7423
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036.132523
IL
207Q00000X
Family Medicine Physician
2010018483
MO
207Q00000X
Family Medicine Physician
Primary
2017007972
MO
Other
Enumeration date
06/21/2010
Last updated
06/28/2023
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