MR. MARK J GLACCUM (NPI# 1205008786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205008786 |
| Entity Type | Individual |
| Full Name | MR. MARK J GLACCUM |
| Credential | DC |
| Practice Address |
415 Gordon Avenue Thomasville GA 31792 |
| Practice Telephone | 2292263101 |
| Practice Fax Number | 2292251745 |
| Mailing Telephone | 2292263101 |
| Mailing Fax Number | 2292251745 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHIR002714 | GA | Chiropractic Providers |
| Street Address |
415 GORDON AVENUE |
| City | THOMASVILLE |
| State | GA |
| Zip Code | 31792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
| 1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
| 1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
| 1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
| 1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
| 1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
| 1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
| 1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
| 1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
| 1154593614 | Earl Douglas Crew Jr Od | Optometrist | 15043 Us Highway 19 South, Thomasville, GA 31792 | 2008-03-25 |
| Find all providers in zip 31792 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053788612 | Lapointe Management Services | Chiropractor | 1102 Smith Ave Ste B, Thomasville, GA 31792-5700 | 2015-08-29 |
| 1720270994 | Jerry Lee Schreiner | Chiropractor | 32620 Highway 43 Ste B, Thomasville, AL 36784-1655 | 2007-08-13 |
| 1487798583 | Todd A. Hanscom, Dc, LLC | Chiropractor | 16820 Us Highway 19 N, Thomasville, GA 31757-7833 | 2007-02-20 |
| 1306988720 | Kristan Wayne Jonasson | Chiropractor | 13 Cloniger Dr, Suite 5, Thomasville, NC 27360-5870 | 2007-02-13 |
| 1346305661 | Heather H. Waldrop | Chiropractor | 202 S Madison St, Thomasville, GA 31792-5479 | 2006-12-27 |
| 1558426866 | Donald G Vinson | Chiropractor | 1971 Ga Highway 122, Thomasville, GA 31757-2500 | 2006-12-27 |
| 1669536066 | James Timothy Willis | Chiropractor | 403 N Crawford St, Thomasville, GA 31792-5128 | 2006-12-20 |
| 1689735359 | William Abner Ball | Chiropractor | 17020 Us Highway 19 N, Thomasville, GA 31757-7852 | 2006-12-13 |
| 1457430795 | Jackson Clinic of Chiropractic Pllc | Chiropractor | 630 National Hwy, Thomasville, NC 27360-2601 | 2006-11-06 |
| 1730270869 | Eugene Francis Berbenick | Chiropractor | 327 E Jackson St Ste B, Thomasville, GA 31792-5175 | 2006-09-27 |
| Find all providers in THOMASVILLE | ||||
| City | THOMASVILLE |
| Zip Code | 31792 |
Please comment or provide details below to improve the information on MR. MARK J GLACCUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.