Provider Demographics
NPI:1134637960
Name:JAMES T. MCGLOWAN JR ARTHROSCOPY SPORTS MEDICINE - BIDCO
Entity Type:Organization
Organization Name:JAMES T. MCGLOWAN JR ARTHROSCOPY SPORTS MEDICINE - BIDCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGLOWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-618-1944
Mailing Address - Street 1:49 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2817
Mailing Address - Country:US
Mailing Address - Phone:781-618-1944
Mailing Address - Fax:781-618-1947
Practice Address - Street 1:49 PEARL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:781-618-1944
Practice Address - Fax:781-618-1947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-15
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty