Provider Demographics
NPI:1013476936
Name:DR GLENN M FLANAGAN MD PA
Entity Type:Organization
Organization Name:DR GLENN M FLANAGAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:392-767-0742
Mailing Address - Street 1:2950 TAMIAMI TRL N STE 13
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4420
Mailing Address - Country:US
Mailing Address - Phone:239-276-7074
Mailing Address - Fax:239-280-0290
Practice Address - Street 1:2950 TAMIAMI TRL N STE 13
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4420
Practice Address - Country:US
Practice Address - Phone:239-276-7074
Practice Address - Fax:239-280-0290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty