Individual
DR. GLENN SCOTT MATHENY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3738 BATTLEGROUND AVE, GREENSBORO, NC 27410-2344
(336) 282-5101
Mailing address
PO BOX 790, PISGAH FOREST, NC 28768-0790
(828) 884-9894
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
850
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09547
BLUE CROSS BLUE SHIELD
NC
01
—
48391
DAVIS
NC
01
—
661290
UNITED HEALTH CARE
NC
05
—
8909547
—
NC
Enumeration date
03/17/2007
Last updated
07/08/2007
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