Individual
GLENN A BUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2416 HWY 435, PICAYUNE, MS 39466
(769) 242-2525
(769) 272-2526
Mailing address
2416 HWY 435, PICAYUNE, MS 39466
(769) 242-2525
(769) 272-2526
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13870R
LA
207R00000X
Internal Medicine Physician
17113
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125336
—
MS
05
—
1439959
—
LA
Enumeration date
10/05/2006
Last updated
08/19/2025
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