Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 12194 | SC |
NPI | 1033352521 |
---|---|
Provider Name | Dr. Kenneth Yorke Gleitsmann |
First Address | Hilton Head Island, SC 29926-6200 |
Second Address | Hilton Head Island, SC 29926-6200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2009 |
Last Update Date | 05/12/2012 |