Individual
DR. GLEN C. KNOWLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
203 WEST MAIN STREET, BRADFORD, AR 72020
(501) 344-2788
(501) 344-8451
Mailing address
PO BOX 70, BRADFORD, AR 72020-0070
(501) 344-2788
(501) 344-8451
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E0193
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125773003
—
AR
Enumeration date
06/24/2005
Last updated
03/15/2010
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