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

Glenn Wilson, IDMT

Individual provider Independent Duty Medical Technicians · NPI 1720401789

Glenn Wilson, IDMT is an Independent Duty Medical Technicians in Holloman AFB, New Mexico. Registered with an NPI since 2014.

In the registry since
2014

Practice location Address checks out

280 David L Goldfein St Bldg 23
Holloman AFB, NM 88330-8273
Phone: (707) 424-5107
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Medical Technicians (primary) Taxonomy 1710I1003X

Record details

NPI number1720401789
Entity typeIndividual (Type 1)
GenderMale
Credentials IDMT
Sole proprietorNo
NPI enumeratedJanuary 28, 2014
Last updated in NPPESMarch 29, 2024
Certification dateMarch 29, 2024
Mailing address228 Seabury St, Suisun City, CA 94585-4107

Other providers in Holloman AFB