Provider Demographics
NPI:1467421933
Name:GLATT, HERBERT J (MD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:J
Last Name:GLATT
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 1:1932 ALCOA HWY STE 255
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1508
Mailing Address - Country:US
Mailing Address - Phone:865-244-2030
Mailing Address - Fax:865-684-1196
Practice Address - Street 1:1932 ALCOA HWY STE 255
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1508
Practice Address - Country:US
Practice Address - Phone:865-244-2030
Practice Address - Fax:865-684-1196
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000019495207WX0200X
TN019495207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0095809OtherBLUE CROSS BLUE SHIELD
0840233OtherUNITED HEALTHCARE
0640843OtherCIGNA
TN0108OtherJOHN DEERE
0647640OtherUMWA
180009851OtherRAILROAD MEDICARE
100011734OtherPHP
TN3047495Medicaid
4600069OtherAETNA
0640843OtherCIGNA
100011734OtherPHP
4600069OtherAETNA