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Individual

GREGORY L LANDRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2880 UNIVERSITY AVE, MADISON, WI 53705
(608) 263-6421
(608) 265-7958
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23993
WI
2080S0010X
Pediatric Sports Medicine Physician
23993
WI

Other

Enumeration date
03/09/2006
Last updated
03/03/2011
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