Provider Demographics
NPI:1861497042
Name:DELP, GLENN RAY (MD)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:RAY
Last Name:DELP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 VAUGHAN MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-6508
Mailing Address - Country:US
Mailing Address - Phone:334-875-4220
Mailing Address - Fax:334-875-5866
Practice Address - Street 1:200 VAUGHAN MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-6508
Practice Address - Country:US
Practice Address - Phone:334-875-4220
Practice Address - Fax:334-875-5866
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00009853208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery