Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 40807 | SC |
N | 207X00000X | Orthopaedic Surgeon | MD.202600 | LA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 29497 | OK |
NPI | 1043400641 |
---|---|
Provider Name | John L Glomset III |
First Address | Norman, OK 73072-1810 |
Second Address | Norman, OK 73072-1810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2007 |
Last Update Date | 16/03/2021 |