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General NPI Number Information
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NPI Number | 1972618056
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Entity Type | Organization
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Legal Business Name | JEFF GLOVER MD PA
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1311 ASTON AVENUE
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City | MCCOMB
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State | MS
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Zip | 39648-2825
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Country | US
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Telephone | 601-684-2481
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Fax | 601-684-2488
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Provider Business Mailing Address
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Address Line | PO BOX 746
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City | MCCOMB
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State | MS
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Zip | 39649-0746
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Country | US
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Telephone | 601-684-2481
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Fax | 601-684-2488
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY HENRY GLOVER
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Credential | MD
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Telephone | 601-684-2481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 10993
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License Number State | MS
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