1154430809 NPI number — DR. GLEN VERNON SAVING JR. PHD

Table of content: DR. GLEN VERNON SAVING JR. PHD (NPI 1154430809)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154430809 NPI number — DR. GLEN VERNON SAVING JR. PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAVING
Provider First Name:
GLEN
Provider Middle Name:
VERNON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154430809
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 COMMUNITY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64735-8804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
660-885-8131
Provider Business Mailing Address Fax Number:
660-885-2393

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
520 BURKARTH RD STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARRENSBURG
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64093-3123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-747-7127
Provider Business Practice Location Address Fax Number:
660-747-1823
Provider Enumeration Date:
08/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  2008009862 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com