Ty Glenn Hargroder MD

NPI 1093761645 - Family Medicine - 207Q00000X

NPI Details
NPI 1093761645
Gender Male
Enumeration Date 05/25/2006
Last Updated 11/21/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
820 S BROADWAY ST
CHURCH POINT LA, 70525-4402, US
Phone (337) 684-5232
Fax
Business Location
820 S BROADWAY ST
CHURCH POINT LA, 70525-4402, US
Phone (337) 684-5232
Fax (337) 684-3434
Toxanomy
Taxonomy Code 207Q00000X
License State Louisiana
License Number 020601
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According to our database, Dr. Ty Glenn Hargroder MD NPI is 1093761645, taxonomy code is 207Q00000X and license number is 020601, license state is located at Louisiana. Ty Glenn Hargroder MD physically located at 820 S Broadway St, Church Point LA, 70525-4402. NPI Number Ty Glenn Hargroder MD has the Individual type.

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1093761645 NPI number is provided on an as is basis without warranty of any kind. 1093761645 is maintained by the National Plan & Provider Enumeration System. The contents of Ty Glenn Hargroder MD are for informational purposes only.