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NPI Code Detail

MEDICARE: CHRISTOPHER C GLISSON DO

MEDICARE:   CHRISTOPHER C GLISSON  DO
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
12084N0400XNeurology Physician5101015360MI
22084N0400XNeurology Physician7556OK

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 : 1932254745
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER C GLISSON DO
Provider Business Mailing Address
First Line : 6600 S YALE AVE STE 1400
Second Line :
City : TULSA
State : OK
Zip : 74136-3331
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6565 S YALE AVE STE 209
Second Line :
City : TULSA
State : OK
Zip : 74136-8303
Country : US
Telephone Number : 918-488-0990
Fax Number : 918-728-8036
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 02/13/2024

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Directions to “ CHRISTOPHER C GLISSON DO” Practice Location

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