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Individual

DR. EARLE GLENN SANFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1602 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-8171
Mailing address
1602 N 2ND ST, CLINTON, MO 64735-1192
(660) 885-8171

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
1065725A
IN
207W00000X
Ophthalmology Physician
Primary
2011001499
MO
207W00000X
Ophthalmology Physician
20730
NE
207W00000X
Ophthalmology Physician
734054
TN

Other

Enumeration date
02/23/2006
Last updated
10/20/2022
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