Individual
DR. GLENN PORTER WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1405 7TH ST SE, DECATUR, AL 35601-3341
(256) 355-6414
(256) 355-6646
Mailing address
PO BOX 1029, DECATUR, AL 35602-1029
(256) 355-6414
(256) 355-6646
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00012567
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000016013
—
AL
01
—
020038026
RR MEDICARE
AL
01
—
1710231
UNITED HEALTH
AL
01
—
51016013WAR
BCBS
AL
Enumeration date
05/12/2006
Last updated
08/05/2013
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