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NPI Code Detail

MEDICARE: JOHN GLICK MD

MEDICARE: JOHN GLICK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician42096CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821103706
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN GLICK MD
Provider Business Mailing Address
First Line : 1000 W 8TH AVE
Second Line :
City : YUMA
State : CO
Zip : 80759-2641
Country : US
Telephone Number : 970-848-3896
Fax Number : 970-848-5475
Provider Business Practice Location Address
First Line : 1000 W 8TH AVE
Second Line :
City : YUMA
State : CO
Zip : 80759-2641
Country : US
Telephone Number : 970-848-3896
Fax Number : 970-848-5475
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 03/24/2021

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Directions to “ JOHN GLICK MD” Practice Location

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