Provider Demographics
NPI:1558304576
Name:TERRY, GLENN C (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:C
Last Name:TERRY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3021 SANDY PKWY
Mailing Address - Street 2:BLDG 2 STE Q
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-1695
Mailing Address - Country:US
Mailing Address - Phone:706-221-0328
Mailing Address - Fax:706-221-0426
Practice Address - Street 1:3021 SANDY PARKWAY
Practice Address - Street 2:BLDG 2 STE Q
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909
Practice Address - Country:US
Practice Address - Phone:706-221-0328
Practice Address - Fax:706-221-0426
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2015-06-30
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Provider Licenses
StateLicense IDTaxonomies
GA022896207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C78983Medicare UPIN
GA$$$$$$$$$AMedicare PIN
AL510I200023Medicare PIN