Individual
DR. JOHN PAUL GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
143 CANAL ST, STE 500, POOLER, GA 31322-6007
(912) 748-4527
(912) 748-9016
Mailing address
143 CANAL ST, STE 500, POOLER, GA 31322-6007
(912) 748-4527
(912) 748-9016
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
065403
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007564665
AETNA
AL
05
—
009934511
—
AL
01
—
0337572
CIGNA
AL
01
—
51000636
BLUE CROSS OF ALABAMA
AL
Enumeration date
06/09/2006
Last updated
01/15/2013
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