Individual
GLENN R LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 MEDICAL CENTER BLVD, SUITE 313N, MARRERO, LA 70072-3151
(504) 371-0071
(507) 371-0272
Mailing address
1111 MEDICAL CENTER BLVD, SUITE 313N, MARRERO, LA 70072-3151
(504) 371-0071
(504) 371-0272
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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