Provider Demographics
NPI:1962424432
Name:GALLASPY, GLENN T (MD)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:T
Last Name:GALLASPY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3715 DAUPHIN ST.
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608
Mailing Address - Country:US
Mailing Address - Phone:251-344-5265
Mailing Address - Fax:251-344-5321
Practice Address - Street 1:3715 DAUPHIN ST.
Practice Address - Street 2:SUITE 2A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-344-5265
Practice Address - Fax:251-344-5321
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2010-03-10
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Provider Licenses
StateLicense IDTaxonomies
AL10248207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC74755Medicare UPIN
AL510-17424Medicare ID - Type Unspecified