NPI 1013622752

Luke Ezekiel Glazener, PAC

Practitioner Physician Assistant Albuquerque, NM

Practice location

Address: 1100 Central Ave SE, Albuquerque, NM 87106-4930
Phone: (505) 841-1125
Mailing address: PO Box 26666 Provider Enrollment, Albuquerque, NM 87125-6666

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA2023-0040 (NM)

Other Physician Assistant providers in New Mexico →

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

Registry record

NPI: 1013622752
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Jan 2023
Record last updated: 17 May 2023

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.