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General NPI Number Information
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NPI Number | 1235343674
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Entity Type | Individual
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Provider Name | SARA GLASSGOW D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 01/02/2024
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Provider Practice Location Address
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Address Line | 2730 CROW CREEK RD
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City | BETTENDORF
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State | IA
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Zip | 52722-2066
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Country | US
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Telephone | 954-399-4673
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Fax | 815-454-2832
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Provider Business Mailing Address
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Address Line | 3601 SW 160TH AVE STE 250
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City | MIRAMAR
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State | FL
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Zip | 33027-6314
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Country | US
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Telephone | 954-399-4673
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO-04637
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-126499
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036-126499
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | DO-04637
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License Number State | IA
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