Individual
DR. GLYNN ADAM GRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3975 I 49 S SERVICE RD, SUITE 105, OPELOUSAS, LA 70570-0775
(337) 948-7680
(337) 948-1143
Mailing address
3975 I 49 S SERVICE RD, SUITE 105, OPELOUSAS, LA 70570-0775
(337) 948-7680
(337) 948-1143
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
011393
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134643
—
LA
Enumeration date
11/03/2005
Last updated
11/02/2007
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