| Doctor Name: | GLEN OWEN MONK |
| NPI Number: | 1790911139 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | E7037 |
| Business Practice Address: | 2400 Sugar Hill Rd Texarkana, AR - 718549264 |
| Business Phone Number: | 5017497445 |
| Business Fax Number: | |
| Mailing Address: | 2400 Sugar Hill Rd, TEXARKANA |
| State: | AR |
| Postal Code: | 718549264 |
| Phone Number: | 5017497445 |
| Fax Number: | |
| NPI Enumeration Date: | 05/29/2009 |
| NPI Last Update Date: | 01/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | E7037 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |