| James E. Gleason Jr, Mdpc | |
|
33 Upper Riverdale Rd Sw Ste 118 Riverdale GA 30274-2642 | |
| (770) 994-6969 | |
| (888) 651-5324 |
| Full Name | James E. Gleason Jr, Mdpc |
|---|---|
| Speciality | Family Medicine |
| Location | 33 Upper Riverdale Rd Sw Ste 118, Riverdale, Georgia |
| Authorized Official Name and Position | James E Gleason (MD) |
| Authorized Official Contact | 7709946969 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James E. Gleason Jr, Mdpc Po Box 962466 Riverdale GA 30296-6923 Ph: (678) 361-8091 | James E. Gleason Jr, Mdpc 33 Upper Riverdale Rd Sw Ste 118 Riverdale GA 30274-2642 Ph: (770) 994-6969 |
| NPI Number | 1013198050 |
|---|---|
| Provider Enumeration Date | 11/19/2007 |
| Last Update Date | 01/17/2024 |
| Medicare PECOS PAC ID | 7517045750 |
|---|---|
| Medicare Enrollment ID | O20080429000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013198050 | NPI | - | NPPES |
| 000573922D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 030466 (Georgia) | Primary |
| Provider Name | James E Gleason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780649368 PECOS PAC ID: 0446338685 Enrollment ID: I20080429000156 |
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