Glenn Edgar Irwin JR.
Emergency Physician General Practice Physician Family Doctor - Adult Medicine
900 Chestnut Street Ext Ste A
Bradford
, Pennsylvania 16701
Glenn Edgar Irwin JR.
Emergency Physician General Practice Physician Family Doctor - Adult Medicine
900 Chestnut Street Ext Ste A
Bradford
, Pennsylvania 16701
(814) 368-8041
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About
Features
Specialties
- Emergency Physician
- Family Doctor - Adult Medicine
- General Practice Physician
Languages spoken
- English
Location
First Address
- Glenn Edgar Irwin JR.
- 900 Chestnut Street Ext Ste A
- Bradford, PA
- Zip : 16701-2298
- Fax : (814) 368-8041
- Phone : (814) 817-2870
Second Address
- Glenn Edgar Irwin JR.
- 900 Chestnut Street Ext Ste A
- Bradford, PA
- Zip : 16701
- Fax : (814) 368-8041
- Phone : (814) 817-2870
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207P00000X | Emergency Physician | MD028763E | PA |
| Y | 207QA0505X | Family Doctor - Adult Medicine | MD028763E | PA |
| N | 208D00000X | General Practice Physician | MD028763E | PA |
National Provider Identifier
| NPI | 1093793598 |
|---|---|
| Provider Name | Glenn Edgar Irwin JR. |
| First Address | Bradford, PA 16701-2298 |
| Second Address | Bradford, PA 16701 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/01/2006 |
| Last Update Date | 31/01/2019 |
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.