Provider Demographics
NPI:1760484117
Name:GLOVER, DAVID BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRUCE
Last Name:GLOVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7303 ROGERS AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4106
Mailing Address - Country:US
Mailing Address - Phone:479-785-2111
Mailing Address - Fax:479-424-2593
Practice Address - Street 1:7303 ROGERS AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4165
Practice Address - Country:US
Practice Address - Phone:479-785-2111
Practice Address - Fax:479-424-2593
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2008-09-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC5352207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR105789001Medicaid
AR152730000-00OtherQUALCHOICE
AR152730000-00OtherQUALCHOICE
AR105789001Medicaid
ARC51867Medicare UPIN