Gladd, Jeffrey E

Gladd, Jeffrey E is an individual health care provider with primary practice located at 1234 E Dupont Rd Suite 3, Fort Wayne IN 46825-1545. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gladd, Jeffrey E can be contacted via phone (260) 373-9965.

Contact Information

Primary practice address
1234 E Dupont Rd Suite 3 Fort Wayne IN 46825-1545
Phone: (260) 373-9965
Fax: (260) 458-5664
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01056652 Indiana

Profile Details

NPI number 1780685768
LBN Legal business name Gladd, Jeffrey E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Sep 22nd, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780685768 NPPES
Indiana Other 000000346257 ANTHEM
Indiana Other 351972384039 ANTHEM
Indiana Other 7059457 ANTHEM
Indiana Other 15705 ANTHEM
Indiana Other 000000570551 ANTHEM
Indiana Other 8194415 ANTHEM
Indiana MEDICAID 200488620A ANTHEM
Indiana Other P00334586 ANTHEM

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