Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 01046162 | IN |
N | 208600000X | Surgeon | 01046162 | IN |
Y | 208200000X | Surgeon | 29587 | KY |
Y | 208600000X | Surgeon | 29587 | KY |
N | 2086S0129X | Vascular Surgeon | 01046162 | IN |
N | 2086S0129X | Vascular Surgeon | 29587 | KY |
NPI | 1053311621 |
---|---|
Provider Name | Dr. Christopher C Glaser |
First Address | Owensboro, KY 42303-1320 |
Second Address | Owensboro, KY 42303-1320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 14/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000048411 | ANTHEM (01) | KY |
020034764 | RAILROAD MEDICARE (01) | |
100329290 | (05) | IN |
100329290 | MOLINA (01) | IN |
611059472 | DART (01) | KY |
611059472 | UMWA (01) | |
6110594722108 | CARESOURCE (01) | IN |
64295876 | (05) | KY |
F57785 | (02) |