Provider Demographics
NPI:1356540942
Name:GLASGOW FAMILY PRACTICE
Entity type:Organization
Organization Name:GLASGOW FAMILY PRACTICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-737-1085
Mailing Address - Street 1:2600 GLASGOW AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4773
Mailing Address - Country:US
Mailing Address - Phone:302-836-8200
Mailing Address - Fax:302-836-4302
Practice Address - Street 1:4633 OGLETOWN STANTON RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2006
Practice Address - Country:US
Practice Address - Phone:302-737-1085
Practice Address - Fax:302-737-4745
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLASGOW FAMILY PRACTICE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE2646541000OtherKEYSTONE AND AMERIHEALTH