Glass, Jon Ryan

Glass, Jon Ryan is an individual health care provider with primary practice located at 1111 Medical Center Blvd S-650, Marrero LA 70072-3151. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Glass, Jon Ryan can be contacted via phone (504) 934-8100.

Contact Information

Primary practice address
1111 Medical Center Blvd S-650 Marrero LA 70072-3151
Fax: (504) 934-8102
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 025041 Louisiana

Profile Details

NPI number 1174522577
LBN Legal business name Glass, Jon Ryan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Jan 17th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174522577 NPPES
Louisiana MEDICAID 1046761

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