Individual provider

GEORGE GLENN GARDNER, PA-C

CMS NPPES lists GEORGE GLENN GARDNER as an individual provider record with NPI 1386885648. The current record reports a primary practice location in ADRIAN, MO and primary taxonomy code 363A00000X.

NPI 1386885648Record type Type 1Primary taxonomy 363A00000X

Type 1 NPIs identify individual healthcare providers. How to read this profile

01

Practice locations

  1. Primary practice location
    102 E. MAIN STADRIAN, MO 647209207

Only source-designated practice locations are shown here. Mailing addresses are not presented as practice locations.

02

Taxonomy information

  • 363A00000XPrimary reported taxonomy

Taxonomy codes describe provider classifications reported to NPPES. Repeated identical codes are shown once, with primary-reported status preserved. They are not licenses, certifications, quality measures, or NPIFolio specialty labels. Read the taxonomy methodology.

03

NPI record information

NPI status
Enumerated in NPPES
Enumeration date
March 17, 2009

An NPI is a federal identifier. Enumeration and lifecycle information does not establish medical-license status, current practice, disciplinary history, provider quality, or whether a provider is accepting patients.