COURTNEY GLENN DPM LLC NPI 1306221106

NPI Information

NPI: 1306221106
Provider Name: COURTNEY GLENN DPM LLC
Classification: Clinic/Center - 261QP1100X
Entity Type: Organization

Specialization: Podiatric

Address:
1515 RIVER PL STE 370
BRASELTON, GA
ZIP 30517
Phone: (770) 648-5040
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COURTNEY GLENN DPM LLC is a podiatric clinic center in Braselton, GA. COURTNEY GLENN DPM LLC NPI is 1306221106. The provider is registered as an organization entity type.

The provider's business location address is:

1515 RIVER PL STE 370
BRASELTON, GA
ZIP 30517-605
Phone: (770) 648-5040
Fax: (706) 780-5366

The provider's authorized official is Courtney Glenn .
The authorized official title is Owner and has the following contact phone number (814) 758-8425.

The enumeration date for this NPI number is 7/22/2015 and was last updated on 1/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP1100X	Clinic/Center	Podiatric	POD001277	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1831454750	OTHER		PERSONAL NPI NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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