George Glenn Gardner PA-C

NPI 1386885648 - Physician Assistant - 363A00000X

NPI Details
NPI 1386885648
Gender Male
Enumeration Date 03/17/2009
Last Updated 08/01/2011
Entity Type Individual
Active Over 7 years ago
Practice Location
102 E. MAIN ST
ADRIAN MO, 64720-9207, US
Phone (816) 297-2640
Fax
Business Location
PO BOX 370
BUTLER MO, 64730-0370, US
Phone (660) 200-7033
Fax (660) 200-7015
Toxanomy
Taxonomy Code 363A00000X
License State Tennessee
License Number 1706
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According to our database, George Glenn Gardner PA-C NPI is 1386885648, taxonomy code is 363A00000X and license number is 1706, license state is located at Tennessee. George Glenn Gardner PA-C physically located at 102 E. Main St, Adrian MO, 64720-9207. NPI Number George Glenn Gardner PA-C has the Individual type.

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1386885648 NPI number is provided on an as is basis without warranty of any kind. 1386885648 is maintained by the National Plan & Provider Enumeration System. The contents of George Glenn Gardner PA-C are for informational purposes only.