Provider Demographics
NPI:1780621136
Name:GLASGOW, ERIN (MD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:GLASGOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 N INDEPENDENCE AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5556
Mailing Address - Country:US
Mailing Address - Phone:405-945-4589
Mailing Address - Fax:405-945-4381
Practice Address - Street 1:3400 NW EXPRESSWAY
Practice Address - Street 2:SUITE 500
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4493
Practice Address - Country:US
Practice Address - Phone:405-945-4589
Practice Address - Fax:405-945-4381
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21566207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKG67693Medicare UPIN
OKG67693Medicare UPIN
OK900522214Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER