Glen P. Imlay
Physical Medicine & Rehabilitation Doctor
98 State St
Proctorville
, Ohio 45669-8163
Glen P. Imlay
Physical Medicine & Rehabilitation Doctor
98 State St
Proctorville
, Ohio 45669-8163
(740) 446-5153
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About
Features
Specialties
- Physical Medicine & Rehabilitation Doctor
Languages spoken
- English
Location
First Address
- Glen P. Imlay
- 90 Jackson Pike
- Gallipolis, OH
- Zip : 45631-1560
- Fax : (740) 446-5153
- Phone : (740) 886-9403
Second Address
- Glen P. Imlay
- 98 State St
- Proctorville, OH
- Zip : 45669-8163
- Fax : (740) 446-5153
- Phone : (740) 886-9403
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation Doctor | 20826 | WV |
| Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 35-08-0873 | OH |
National Provider Identifier
| NPI | 1053364828 |
|---|---|
| Provider Name | Glen P. Imlay |
| First Address | Gallipolis, OH 45631-1560 |
| Second Address | Proctorville, OH 45669-8163 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/05/2006 |
| Last Update Date | 21/01/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000185246 | UNISON MEDICAID (01) | OH |
| 000000227912 | ANTHEM BCBS (01) | |
| 001714143 | MOUNTAIN STATE BCBS (01) | |
| 2003261000 | (05) | WV |
| 2333906 | (05) | OH |
| 2333906 | MOLINA MEDICAID (01) | OH |
| 250013535 | RR MEDICARE (01) | |
| 310917085124 | CARESOURCE MEDICAID (01) | OH |
| H62526 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.