NPI 1003219304

Charles C Glass, PAC

Practitioner Physician Assistant Leavenworth, KS

Practice location

Address: 3550 S 4th St STE 250, Leavenworth, KS 66048-5061
Phone: (913) 565-2569
Fax: (913) 565-2571
Mailing address: 2200 SW 6th Ave STE 104, Topeka, KS 66606-1707

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 15-01742 (KS)

Other Physician Assistant providers in Kansas →

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 2015022139 (MO)

Registry record

NPI: 1003219304
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Sep 2014
Record last updated: 8 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.