Individual
JACK GLASSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1325 ANDREA ST, SUITE 100, BOWLING GREEN, KY 42104-5852
(270) 901-3454
(270) 901-3458
Mailing address
3 MARYLAND FARMS, SUITE 250, BRENTWOOD, TN 37027-5005
(615) 373-7600
(866) 346-1426
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19937
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000065732
ANTHEM
KY
01
—
080155383
RAILROAD MEDICARE
KY
01
—
50006908
PASSPORT
KY
05
—
64199375
—
KY
Enumeration date
06/21/2005
Last updated
10/10/2014
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