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Individual

DR. JOHN R. GLEASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
033584
GA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
033584
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000442692D
GA
05
000442692F
GA
Enumeration date
09/30/2005
Last updated
09/11/2009
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