Individual
MR. DALE BEAIRD GLOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1401 FOUCHER ST FL 5, NEW ORLEANS, LA 70115-3515
(504) 897-7999
(504) 897-7676
Mailing address
CRESCENT CITY PHYSICIANS, INC., 3600 PRYTANIA ST., STE. 35, NEW ORLEANS, LA 70115-3678
(504) 897-7197
(504) 249-5311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA04743
TX
363AM0700X
Medical Physician Assistant
Primary
200155
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2131991
—
LA
Enumeration date
08/08/2006
Last updated
02/28/2019
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