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General NPI Number Information
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NPI Number | 1558304576
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Entity Type | Individual
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Provider Name | GLENN C. TERRY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 3021 SANDY PARKWAY BLDG 2 STE Q
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City | COLUMBUS
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State | GA
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Zip | 31909
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Country | US
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Telephone | 706-503-5057
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Fax |
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Provider Business Mailing Address
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Address Line | 3021 SANDY PKWY BLDG 2 STE Q
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City | COLUMBUS
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State | GA
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Zip | 31909-1695
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Country | US
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Telephone | 706-503-5057
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Fax | 706-243-4277
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 22896
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 022896
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License Number State | GA
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