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Organization

COLLIER B. GLADIN, JR., M.D., LLC

Active
Parent organization
COLLIER B. GLADIN, JR. M.D., LLC
Other names
Collier B Gladin Jr MD
Organization subpart
Yes

Provider details

NPI number
Legal business name
COLLIER B. GLADIN, JR. M.D., LLC
Authorized official
DR. COLLIER B. GLADIN JR. M.D. (OWNER)
(478) 757-8335
Entity
Organization

Contact information

Practice address
140 NORTHCREST BLVD., MACON, GA 31210
(478) 757-8335
(478) 757-8353
Mailing address
140 NORTHCREST BLVD., MACON, GA 31210
(478) 757-8335
(478) 757-8353

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
030609
GA
305R00000X
Preferred Provider Organization
030609
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000383446D
GA
01
D29570
UPIN
GA
Enumeration date
09/20/2010
Last updated
03/07/2023
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