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Individual

GLENN R LANDRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
011421
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1021299
AETNA
LA
05
1151378
LA
01
1900174
UNITED HEALTHCARE
LA
01
4367671004
CIGNA
LA
Enumeration date
07/08/2005
Last updated
07/09/2007
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