Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 2005015555 | MO |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 2005015555 | MO |
NPI | 1164424461 |
---|---|
Provider Name | Dr. Dennis N Glascock |
First Address | Bridgeton, MO 63044-2527 |
Second Address | St Charles, MO 63301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 08/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201876 | BLUE PRODUCTS (01) | MO |
207277203 | (05) | MO |
4649526 | AETNA (01) | MO |
562517372 | UNITED HEALTHCARE (01) | MO |
6407746 | CIGNA (01) | MO |
725773 | HEALTHLINK (01) | MO |
E36548 | (02) | |
P00304610 | RAILROAD MEDICARE (01) | MO |