Healthcare Provider Details

I. General information

NPI: 1356543177
Provider Name (Legal Business Name): MERIDEN A GLASGOW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 01/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 VIRGINIA DR
BATESVILLE AR
72501-7337
US

IV. Provider business mailing address

305 VIRGINIA DR
BATESVILLE AR
72501-7337
US

V. Phone/Fax

Practice location:
  • Phone: 870-698-0300
  • Fax:
Mailing address:
  • Phone: 870-698-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberE5456
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: