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General NPI Number Information
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NPI Number | 1336399401
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Entity Type | Organization
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Legal Business Name | DONALD K. GLOVER, D.O., P.C.
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Dates
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Enumeration Date | 09/25/2008
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 657A W MAPLE ST
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City | FARMINGTON
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State | NM
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Zip | 87401-5967
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Country | US
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Telephone | 505-326-4546
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Fax | 505-325-0689
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Provider Business Mailing Address
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Address Line | 657A W MAPLE ST
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City | FARMINGTON
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State | NM
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Zip | 87401-5967
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Country | US
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Telephone | 505-326-4546
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Fax | 505-325-0689
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONALD K GLOVER JR.
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Credential | D.O.
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Telephone | 505-326-4546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A76683
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License Number State | NM
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