Glazebrook, George W

Glazebrook, George W is an individual health care provider with primary practice located at 80 Interstate South Dr Ste B, Jasper GA 30143-6226. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Glazebrook, George W can be contacted via phone (706) 692-9081.

Contact Information

Primary practice address
80 Interstate South Dr Ste B Jasper GA 30143-6226
Phone: (706) 692-9081
Fax: (706) 692-0155
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 16348 Georgia

Profile Details

NPI number 1245292119
LBN Legal business name Glazebrook, George W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Jan 23rd, 2012 - about 14 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 1245292119 NPPES
Georgia MEDICAID 00038519A
Georgia Other 020034782
Georgia Other 102136

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