Provider Demographics
NPI:1902904089
Name:MCGLONE, JEFF (MD)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:MCGLONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 BURR RD.
Mailing Address - Street 2:
Mailing Address - City:CORNISH FLAT
Mailing Address - State:NH
Mailing Address - Zip Code:03746
Mailing Address - Country:US
Mailing Address - Phone:603-469-3965
Mailing Address - Fax:
Practice Address - Street 1:243 ELM ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-4921
Practice Address - Country:US
Practice Address - Phone:603-469-3965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9455207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology