Individual
ETHAN L GREENBLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8585 PICARDY AVE, BATON ROUGE, LA 70809-3748
(225) 763-4764
(225) 763-4549
Mailing address
7373 PERKINS RD, BATON ROUGE, LA 70808-4373
(225) 246-9790
(225) 246-9100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
325987
LA
207R00000X
Internal Medicine Physician
A154636
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2016
Last updated
05/03/2021
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