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NPI Code Detail

MEDICARE: DR. JOSIAH GLISE DO

MEDICARE: DR. JOSIAH GLISE DO
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 Program

General Provider Information

NPI Number : 1467398008
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSIAH GLISE DO
Provider Business Mailing Address
First Line : 1125 N COLLEGE AVE
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-1908
Country : US
Telephone Number : 479-521-0263
Fax Number :
Provider Business Practice Location Address
First Line : 1125 N COLLEGE AVE
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-1908
Country : US
Telephone Number : 479-463-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2026
Last Update Date : 05/21/2026

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Directions to “ DR. JOSIAH GLISE DO” Practice Location

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