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DR. GLENN O ARCHIBALD MD
Psychiatry >> Psychiatry & Neurology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1316947450
Individual Registrant:DR. GLENN O ARCHIBALD MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
1302 NOBLE ST STE. 3D ANNISTON, AL 36201-4678 US
Tel: 256-546-9265 Fax: 256-549-0376
Tel: 256-546-9265 Fax: 256-549-0376
Contact information for business:
3001 SCENIC HIGHWAY GADSDEN, AL 35904-3047 US
Tel: 256-546-9265 Fax: 256-549-0376
Tel: 256-546-9265 Fax: 256-549-0376
Registration Information:
NPI: 1316947450
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 2084P0800X | Allopathic & Osteopathic Physicians Psychiatry & Neurology Psychiatry | AL | 16043 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| DEA | BA1675315 | AL | 01 |
| MEDICAL LICENSE | 16043 | AL | 01 |
