Individual
PHILIP GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4614 E SHEA BLVD, D-110, PHOENIX, AZ 85028-3070
(480) 404-3700
Mailing address
4614 E SHEA BLVD, D-110, PHOENIX, AZ 85028-3070
(480) 404-3700
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
30105
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
696065
—
AZ
Enumeration date
08/16/2005
Last updated
07/08/2007
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