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Individual

DR. GLENN E HARNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1680 MONTGOMERY HWY, HOOVER, AL 35216-4906
(205) 979-0888
(205) 979-4110
Mailing address
2147 RIVERCHASE OFFICE RD, HOOVER, AL 35244-1836
(205) 421-2122
(205) 982-7882

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
052451
GA
207P00000X
Emergency Medicine Physician
27336
SC
208D00000X
General Practice Physician
Primary
31023
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10058667
AMERIGROUP
GA
05
801486406A
GA
05
801486406B
GA
05
801486406D
GU
05
801486406E
GA
05
801486406F
SC
05
801486406H
GA
05
G52451
SC
Enumeration date
06/07/2006
Last updated
08/18/2011
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