Provider Demographics
NPI:1750384525
Name:GLANDON, KAREN (DPM)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GLANDON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 498922
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-8922
Mailing Address - Country:US
Mailing Address - Phone:513-787-3964
Mailing Address - Fax:
Practice Address - Street 1:1175 NOE BIXBY RD # B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-3530
Practice Address - Country:US
Practice Address - Phone:513-787-3964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003087213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2072162Medicaid
OH480033904OtherRAILROAD MEDICARE
OH2072162Medicaid
OH480033904OtherRAILROAD MEDICARE