Glenn Ivan Bascon, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

17475 Issued in GA

Practice address

Dwight David Eisenhower Army Medical Center
300 East Hospital Road
Fort Eisenhower, GA 30905-5650

Phone

(706) 787-9399

NPI assigned

May 12, 2025

Last updated

Jul 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1821888744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 EAST HOSPITAL ROAD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "30905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DWIGHT DAVID EISENHOWER ARMY MEDICAL CENTER",
            "address_2": "300 EAST HOSPITAL ROAD",
            "city": "FORT EISENHOWER",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASCON",
        "first_name": "GLENN",
        "middle_name": "IVAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "17475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip A Aubrey, MD
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• Jesica Baker, PA-C
• Ascharya Balaji
• Kimberley Yvonne Banta, LPC
• Ryan Hartwell Becker, DO
• Michael Donald Beres, M.D.
• Spencer Blankenship, OTD
• David Edward Bonnin, MD
• Benjamin Brainerd

• Student in an Organized Health Care Education/Training Program in Fort Eisenhower, GA
• Providers in Fort Eisenhower, GA by specialty
• Student in an Organized Health Care Education/Training Program in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.