Organization · NPI-2

Dr Glenn C Stow PLLC

General Practice · Shawnee, OK

NPI number1396924072
StatusActive
Last updated in NPPESMay 1, 2012

Details

NPI
1396924072
Entity type
Organization (NPI-2)
Legal business name
Dr Glenn C Stow PLLC
Organization subpart
No
Enumeration date
Oct 30, 2007
Last updated
May 1, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General Practice20824OKYes

Practice location

2304 N Harrison St
Shawnee, OK 74804-3135

Phone 405-273-0313

Mailing address

Po Box 268988
Oklahoma City, OK 73126-8988

Authorized official

Glenn C Stow
Physician
4052730313

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other General Practice providers in Shawnee, OK