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General NPI Number Information
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NPI Number | 1962534966
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Entity Type | Organization
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Legal Business Name | ALDEN B GLIDDEN MDPC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 10/14/2007
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Provider Practice Location Address
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Address Line | 2680 UHRMANN RD STE B
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City | KLAMATH FALLS
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State | OR
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Zip | 97601-1174
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Country | US
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Telephone | 541-882-8823
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Fax | 541-883-6481
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Provider Business Mailing Address
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Address Line | 2680 UHRMANN RD STE B
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City | KLAMATH FALLS
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State | OR
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Zip | 97601-1174
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Country | US
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Telephone | 541-882-8823
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Fax | 541-883-6481
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALDEN B. GLIDDEN
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Credential | M.D.
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Telephone | 541-882-8823
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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 | OR7620
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License Number State | OR
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