Individual
JAMES E GLEASON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33 UPPER RIVERDALE RD SW STE 118, RIVERDALE, GA 30274-2642
(770) 994-6969
(888) 651-5324
Mailing address
PO BOX 962466, RIVERDALE, GA 30296-6923
(770) 994-6969
(888) 651-5324
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
030466
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005739ZZD
—
GA
Enumeration date
04/18/2006
Last updated
01/16/2024
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