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Glenn Champagne, MD
General Practice Physician in Malone, New York
NPI 1487869087

Glenn Champagne is a General Practice Physician based in Malone, NY. Glenn Champagne practices in Malone, NY and has the professional credentials of MD. The NPI Number for Glenn Champagne is 1487869087 and holds a License No. 127279-1 (New York).

The current practice location address for Glenn Champagne is Bare Hill Road, Malone, NY and can be reached out via phone at 518-483-6040.

Location: Bare Hill Road, Malone, NY, 12953-3819
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487869087
Provider Name
Glenn Champagne
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
Bare Hill Road, Malone, NY, 12953-3819
Phone Number
518-483-6040
Fax Number
Provider Enumeration Date
05/14/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00632522 05 NY
institution
Provider Business Practice Location Address Details
Address
Bare Hill Road
City
Malone
State
New York
Zip
12953
Phone Number
518-483-6040
Fax Number
person
Provider Business Mailing Address Details
Address
Bare Hill Road
City
Malone
State
New York
Zip
12953
Phone Number
518-483-6040
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
127279-1 (New York)
Definition
Definition to come...
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