Individual
JOHN GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 W 8TH AVE, YUMA, CO 80759-2641
(970) 848-3896
(970) 848-5475
Mailing address
1000 W 8TH AVE, YUMA, CO 80759-2641
(970) 848-3896
(970) 848-5475
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42096
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20932782
—
CO
Enumeration date
08/20/2006
Last updated
03/24/2021
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