Provider Demographics
NPI:1063480937
Name:GLOVER, RICHARD M II (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:M
Last Name:GLOVER
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:700 MEDICAL CENTER DR
Mailing Address - Street 2:STE 210
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-9017
Mailing Address - Country:US
Mailing Address - Phone:316-283-2800
Mailing Address - Fax:316-283-3575
Practice Address - Street 1:700 MEDICAL CENTER DR
Practice Address - Street 2:STE 210
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-9017
Practice Address - Country:US
Practice Address - Phone:316-283-2800
Practice Address - Fax:316-283-3575
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
KS04-22805207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100127670AMedicaid
BG1975323OtherDEA
BG1975323OtherDEA
E65705Medicare UPIN