| George Russell Glenn, MD PHD | |
|
Internal Medicine Clinic, 1801 Sunset Drive, Columbia, SC 29203 | |
| (803) 434-4153 | |
| (803) 434-4160 |
| Full Name | George Russell Glenn |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 7 Years |
| Location | Internal Medicine Clinic, Columbia, South Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396239125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 95127 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Francis Medical Center | Peoria, IL | Hospital |
| Ottawa Regional Hospital Dba Osf Saint Elizabeth Mdl Ctr | Ottawa, IL | Hospital |
| Bellin Health Oconto Hospital | Oconto, WI | Hospital |
| St Joseph Medical Center | Bloomington, IL | Hospital |
| Bellin Memorial Hospital | Green bay, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Radiology Chartered | 1557394988 | 17 |
| Central Illinois Radiological Associates Ltd | 9436061827 | 162 |
| Entity Name | Central Illinois Radiological Associates Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538192828 PECOS PAC ID: 9436061827 Enrollment ID: O20171103002605 |
| Entity Name | Radiology Chartered |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760416895 PECOS PAC ID: 1557394988 Enrollment ID: O20240220003695 |
| Mailing Address | Practice Location Address |
|---|---|
| George Russell Glenn, MD PHD 2825 Oak Lawn Ave Unit 192749, Dallas, TX 75219-4688 Ph: (510) 683-9500 | George Russell Glenn, MD PHD Internal Medicine Clinic, 1801 Sunset Drive, Columbia, SC 29203 Ph: (803) 434-4153 |
Dr. Jason P Eastlack, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1519 Marion St, Columbia, SC 29201 Phone: 803-296-5954 Fax: 803-296-3076 | |
Heather Burch, D.O. Radiology Medicare: Not Enrolled in Medicare Practice Location: 4500 8th Division Rd, Columbia, SC 29207 Phone: 803-751-2339 | |
Dr. James Joseph Farrell, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: Wjb Dorn Vamc, 6439 Garners Ferry Road, Columbia, SC 29209 Phone: 803-695-6811 Fax: 803-695-6745 | |
Dr. Raleigh J Boulware, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 7 Medical Park, Suite 104, Columbia, SC 29223 Phone: 803-434-3400 Fax: 803-434-3938 | |
Gerald Edmund Richmond, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 2000 Park St, Columbia, SC 29201 Phone: 803-462-3770 Fax: 803-462-3771 | |
Dr. Robert Wesley Smith, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 5 Richland Medical Park Dr, Columbia, SC 29203 Phone: 803-434-7000 | |
Nichole Holmes, RT(R, CT) Radiology Medicare: Not Enrolled in Medicare Practice Location: 6439 Garners Ferry Rd, Columbia, SC 29209 Phone: 803-776-4000 |