Individual
JOHN GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1440 E COUNTY LINE RD, ST 1200, INDIANAPOLIS, IN 46227-0963
(317) 497-6270
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001956A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005120
—
IN
Enumeration date
12/31/2015
Last updated
11/27/2023
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