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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

GLEN EDWARD DIACON JR., MD

Active Sole Proprietor

GLEN EDWARD DIACON JR., MD is a Specialist healthcare provider located in ADA, Oklahoma. NPI 1588659957 is currently active in the NPPES registry. Verify at CMS.

Specialist · ADA, OK

Registration Details

NPI Number
1588659957
Provider Type
Individual
Gender
Male
NPI Issued
Sep 13, 2005 (20.774191486957 yrs)
Last Updated
Aug 11, 2010
License
16231 (OK)
Sole Proprietor
Yes

Practice Information

Address
1414 ARLINGTON ST
SUITE 2300
ADA, OK, 748202643
Browse OK providers · Browse ZIP 74820
Phone
5803320112
Fax
5803321005
Primary Specialty
Specialist
174400000X

Other Specialist Providers in ADA, OK

Name Credential NPI
DR. TERRENCE H BORING MD 1487654836
TAWFIK RAMADAN MD 1548252299
DR. DONALD WESLEY DAVIES MD 1730214578
MR. LARRY PAUL PENWRIGHT JR. HIS 1609909142
MR. JASON LEE PRATHER ATC 1932221793
MRS. DEBRA J COX IBCLC,RLC 1013190529
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.