Glen Halvorson MD PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

13423 Issued in AZ

Legal business name

GLEN HALVORSON MD PLLC

Practice address

4550 E Bell Rd
Ste 150
Phoenix, AZ 85032-9306

Phone

(602) 795-3649

Fax

(602) 795-3996

NPI assigned

Apr 4, 2016

Last updated

Feb 17, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Glen A Halvorson, MDNPI 1588754873

Title

Owner

Phone

(602) 795-3649

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glen Allen Halvorson, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1588754873
  Authorized official Same address or phone

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1982067179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 E BELL RD",
            "address_2": "STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850329306",
            "telephone_number": "602-795-3674",
            "fax_number": "602-795-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 E BELL RD",
            "address_2": "STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850329306",
            "telephone_number": "602-795-3649",
            "fax_number": "602-795-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN HALVORSON MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-04",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "HALVORSON",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-795-3649",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "13423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Gleason, MD
• Renee Gleason II
• Garrett Gleaves, CRNA
• Jocelyn Rose Gledhill, RN CLC
• David J Glembocki, MD
• Glenbo, LLC (Right at Home)
• Glendale Chiropractic PLLC
• Glendale Dentistry Group (Arizona Aesthetic Dentistry)
• Glendale Medical Center
• Glendale Medical Center PLLC (Camelback Pain Centers)

• Physical Medicine & Rehabilitation Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; 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.