Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Glen Edward Diacon Jr., MD

Individual provider Specialist · NPI 1588659957

Glen Edward Diacon Jr., MD is an Urology in Ada, Oklahoma. Graduated from University of Oklahoma College of Medicine in 1986, 40 years ago. Practices with Southern Oklahoma Urology, Inc, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oklahoma.

Years since qualifying
40
Trained at
University of Oklahoma College of Medicine
Licensed in
OK
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1414 Arlington St Ste 2300
Ada, OK 74820-2643
Phone: (580) 332-0112
Fax: (580) 332-1005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 16231 (OK)

Record details

NPI number1588659957
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 13, 2005
Last updated in NPPESAugust 11, 2010

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolUNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduated 1986 (40 years in practice)
Group practice Southern Oklahoma Urology, Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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