Individual
GLENN PATRICK KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4200 HOUMA BLVD FL 2, METAIRIE, LA 70006-2970
(504) 454-4102
(504) 454-4192
Mailing address
4200 HOUMA BLVD FL 2, METAIRIE, LA 70006-2970
(504) 454-4102
(504) 454-4192
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD.025489
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1575755
—
LA
Enumeration date
06/28/2006
Last updated
12/22/2016
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