Granger, Glynn Adam
Granger, Glynn Adam is an individual health care provider with primary practice located at 3975 I 49 S Service Rd Suite 105, Opelousas LA 70570-0775. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Granger, Glynn Adam can be contacted via phone (337) 948-7680.Contact Information
Primary practice address
3975 I 49 S Service Rd Suite 105
Opelousas LA 70570-0775
Phone: (337) 948-7680
Fax: (337) 948-1143
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 011393 | Louisiana |
Profile Details
| NPI number | 1629069034 |
|---|---|
| LBN Legal business name | Granger, Glynn Adam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2005 |
| Last updated | Nov 2nd, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629069034 | NPPES |
| Louisiana | MEDICAID | 1134643 |
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