Smith, Glenn A

Smith, Glenn A is an individual health care provider with primary practice located at 2219 Garfield St , Two Rivers WI 54241. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Smith, Glenn A can be contacted via phone (920) 793-2281.

Contact Information

Primary practice address
2219 Garfield St Two Rivers WI 54241
Phone: (920) 793-2281
Fax: (920) 793-3669
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 31392 Wisconsin
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 31392 Wisconsin

Profile Details

NPI number 1295842409
LBN Legal business name Smith, Glenn A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2006
Last updated Jan 15th, 2024 - about 2 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 1295842409 NPPES
Wisconsin MEDICAID 31673600

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