Wallace E Gladden Jr. (NPI# 1689803827, PAC ID# 9638321409) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1689803827 |
| PAC ID by PECOS | 9638321409 |
| Professional Enrollment ID | I20171128002840 |
| Full Name | Wallace E Gladden Jr. |
| Organization Legal Name | MANZANO MEDICAL GROUP, P.C. |
| Address |
505 Elm St Ne Manzano Medical Group PC Albuquerque NM 87102-2500 |
| Phone Number | 5057274919 |
| Gender | M |
| Medical School | HOWARD UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 2009 |
| Primary Specialty | GENERAL PRACTICE |
| Secondary Specialties | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 9830093707 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 505 Elm St Ne, Manzano Medical Group PC, Albuquerque, NM 87102-2500 | 5057274919 | MANZANO MEDICAL GROUP, P.C. |
| Organization Legal Name | MANZANO MEDICAL GROUP, P.C. |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Athanasios K Manole | Physical Medicine and Rehabilitation | Manzano Medical Group, P.C. | 505 Elm St Ne, Manzano Medical Group PC, Albuquerque, NM 87102-2500 |
| John H Sloan | Physical Medicine and Rehabilitation | Manzano Medical Group, P.C. | 505 Elm St Ne, Manzano Medical Group PC, Albuquerque, NM 87102-2500 |
| Street Address |
505 ELM ST NE MANZANO MEDICAL GROUP PC |
| City | ALBUQUERQUE |
| State | NM |
| Zip | 87102-2500 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Athanasios K Manole | Physical Medicine and Rehabilitation | Manzano Medical Group, P.C. | 505 Elm St Ne, Manzano Medical Group PC, Albuquerque, NM 87102-2500 |
| John H Sloan | Physical Medicine and Rehabilitation | Manzano Medical Group, P.C. | 505 Elm St Ne, Manzano Medical Group PC, Albuquerque, NM 87102-2500 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Justin Richard White | Nurse Practitioner | Lovelace Health System LLC | 601 Martin Luther King Jr Ave Ne, Albuquerque, NM 87102 |
| Amanda G Wilder | Clinical Social Worker | 200 Rosemont Ave Ne, Albuquerque, NM 87102-1569 | |
| Rachel L Rogers | Clinical Social Worker | 200 Rosemont Ave Ne, Suite D, Albuquerque, NM 87102-1599 | |
| Elaine K Padilla | Clinical Social Worker | Outcomes Inc | 1503 University Blvd Ne, Albuquerque, NM 87102-1708 |
| Kathryn Fehr | Clinical Social Worker | Outcomes Inc | 1503 University Blvd Ne, Albuquerque, NM 87102-1708 |
| Daniel Crowder | Clinical Social Worker | Outcomes Inc | 1503 University Blvd Ne, Albuquerque, NM 87102-1708 |
| Claire Greene | Clinical Social Worker | Outcomes Inc | 1503 University Blvd Ne, Albuquerque, NM 87102-1708 |
| Scott S Stoerner | Rheumatology | Albuquerque Center for Rheumatology PC | 1617 University Blvd Ne, Albuquerque, NM 87102-1710 |
| Jacqueline K Dean | Rheumatology | Albuquerque Center for Rheumatology PC | 1617 University Blvd Ne, Albuquerque, NM 87102-1710 |
| Leroy A Pacheco | Rheumatology | Albuquerque Center for Rheumatology PC | 1617 University Blvd Ne, Albuquerque, NM 87102-1710 |
| Find all physicians in zip 87102 | |||
| City | ALBUQUERQUE |
| Zip Code | 87102 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | ALBUQUERQUE + GENERAL PRACTICE |
Please comment or provide details below to improve the information on Wallace E Gladden Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.