Individual
DR. GLENN DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O., MPH
Contact information
Practice address
1381 S PATRICK DR, PATRICK AFB, FL 32925-3606
(318) 828-3856
Mailing address
1381 S PATRICK DR, PATRICK AFB, FL 32925-3606
(318) 828-3856
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
L6867
TX
Other
Enumeration date
01/19/2006
Last updated
11/15/2012
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