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General NPI Number Information
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NPI Number | 1942424668
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Entity Type | Organization
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Legal Business Name | EARL G GLOECKNER, M.D., LTD
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 1420 7TH ST
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City | MOLINE
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State | IL
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Zip | 61265-2916
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Country | US
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Telephone | 309-762-2333
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Fax | 309-762-8001
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Provider Business Mailing Address
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Address Line | 1420 7TH ST
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City | MOLINE
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State | IL
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Zip | 61265-2916
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Country | US
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Telephone | 309-762-2333
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Fax | 309-762-8001
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EARL G GLOECKNER
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Credential | M.D.
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Telephone | 309-762-2333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | IL
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