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NPI Code Detail

MEDICARE: JAMES MICHAEL GLENN M.D.

MEDICARE: JAMES MICHAEL GLENN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianME63572FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
118895OTHERFLBCBS
23525756OTHERFLCIGNA
35681078OTHERFLAETNA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336143320
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MICHAEL GLENN M.D.
Provider Business Mailing Address
First Line : 2338 COUNTY HIGHWAY 280 E
Second Line :
City : DEFUNIAK SPRINGS
State : FL
Zip : 32435-5623
Country : US
Telephone Number : 850-420-6566
Fax Number :
Provider Business Practice Location Address
First Line : 744 S WEBSTER AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-3505
Country : US
Telephone Number : 850-420-6566
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 03/06/2024

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