Organization Active NPI

Jeff Glover MD PA

  • Surgery Physician
  • McComb, MS
National Provider Identifier
1972618056
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
10993 Issued in MS
Legal business name
JEFF GLOVER MD PA
Practice address
1311 Aston Avenue
McComb, MS 39648-2825
Phone
(601) 684-2481
Fax
(601) 684-2488
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jeffrey Henry Glover, MD
Title
President
Phone
(601) 684-2481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 10993 MS Primary

Addresses

Primary practice location

1311 Aston Avenue
McComb, MS 39648-2825

Mailing address

PO Box 746
McComb, MS 39649-0746
Phone (601) 684-2481

Other identifiers 4

IdentifierTypeStateIssuer
5023171OtherMSAETNA
00016354MedicaidMS
1730117OtherMSUNITED HEALTHCARE
1387509OtherLALOUISIANA MEDICAID

Other names 1

  • Jeffrey H Glover MD Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972618056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490746",
            "telephone_number": "601-684-2481",
            "fax_number": "601-684-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 ASTON AVENUE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482825",
            "telephone_number": "601-684-2481",
            "fax_number": "601-684-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF GLOVER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-684-2481",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MS",
            "license": "10993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5023171",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00016354",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1730117",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA MEDICAID",
            "identifier": "1387509",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey H Glover MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.