Individual
DR. GREGORY LYON GLOWACKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1555 GARY DR STE A, BREAUX BRIDGE, LA 70517-3448
(337) 909-2474
(337) 909-2479
Mailing address
PO BOX 53247, LAFAYETTE, LA 70505-3247
(337) 289-8780
(337) 571-0010
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.015143
LA
208000000X
Pediatrics Physician
015143
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1321010
—
LA
Enumeration date
07/05/2006
Last updated
12/09/2020
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