Provider Demographics
NPI:1477952190
Name:QUARLES, GLENN RICHARD JR (DO)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:RICHARD
Last Name:QUARLES
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2331 FRANKLIN RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1111
Mailing Address - Country:US
Mailing Address - Phone:540-510-6200
Mailing Address - Fax:540-857-5306
Practice Address - Street 1:2331 FRANKLIN RD SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014
Practice Address - Country:US
Practice Address - Phone:540-510-6200
Practice Address - Fax:540-857-5306
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2022-09-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102205319208100000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation