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1275647877 NPI number — ELLEN SUE GLOTZBACH MD

NPI Number: 1275647877
Health Care Provider/Practitioner: ELLEN SUE GLOTZBACH MD

Information about “1275647877” NPI (ELLEN SUE GLOTZBACH MD) exists in 1275647877 in HTML format HTML  |  1275647877 in plain Text format TXT  |  1275647877 in PDF (Portable Document Format) PDF  |  1275647877 in an XML format XML  formats.

NPI Number : 1275647877 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1275647877",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GLOTZBACH",
    "FirstName": "ELLEN",
    "MiddleName": "SUE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ALLEGRI",
    "OtherFirstName": "ELLEN",
    "OtherMiddleName": "SUE",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "1004 CARONDELET DR",
    "SecondLineMailingAddress": "SUITE 310",
    "MailingAddressCityName": "KANSAS CITY",
    "MailingAddressStateName": "MO",
    "MailingAddressPostalCode": "64114-4802",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "816-942-5437",
    "MailingAddressFaxNumber": "816-942-4830",
    "FirstLinePracticeLocationAddress": "1004 CARONDELET DR",
    "SecondLinePracticeLocationAddress": "SUITE 310",
    "PracticeLocationAddressCityName": "KANSAS CITY",
    "PracticeLocationAddressStateName": "MO",
    "PracticeLocationAddressPostalCode": "64114-4802",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "816-942-5437",
    "PracticeLocationAddressFaxNumber": "816-942-4830",
    "EnumerationDate": "08/19/2006",
    "LastUpdateDate": "06/17/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "R6H97",
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": "0422185",
          "LicenseNumberStateCode": "KS",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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