Provider Demographics
NPI:1356938088
Name:J. D. GLOOR, M. D., INC.
Entity type:Organization
Organization Name:J. D. GLOOR, M. D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GLOOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:401-294-8200
Mailing Address - Street 1:7260 POST RD STE 103
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-3246
Mailing Address - Country:US
Mailing Address - Phone:401-294-8200
Mailing Address - Fax:401-294-8222
Practice Address - Street 1:7260 POST RD STE 103
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-3246
Practice Address - Country:US
Practice Address - Phone:401-294-8200
Practice Address - Fax:401-294-8222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty