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NPI Code Detail

MEDICARE: TALN JAMES GLIDEWELL

MEDICARE:   TALN JAMES GLIDEWELL
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
1390200000XStudent in an Organized Health Care Education/Training ProgramOK

General Provider Information

NPI Number : 1457284259
Entity Type Code : Individual
Provider Name (Legal Business Name) : TALN JAMES GLIDEWELL
Provider Business Mailing Address
First Line : 505 E 2ND ST APT 1237
Second Line :
City : TULSA
State : OK
Zip : 74120-1824
Country : US
Telephone Number : 405-999-6686
Fax Number :
Provider Business Practice Location Address
First Line : 1111 W 17TH ST
Second Line :
City : TULSA
State : OK
Zip : 74107-1800
Country : US
Telephone Number : 918-582-1972
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ TALN JAMES GLIDEWELL ” Practice Location

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