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Individual

KYLE GLISSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 896-9534
Mailing address
2000 2ND AVE S APT 518, BIRMINGHAM, AL 35233-2087

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
336110
LA
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
03/24/2020
Last updated
01/24/2024
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