Provider Demographics
NPI:1477518439
Name:CASEY, GLENN A (MD)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:A
Last Name:CASEY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2820 NAPOLEON AVE
Mailing Address - Street 2:#650
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115
Mailing Address - Country:US
Mailing Address - Phone:504-899-1114
Mailing Address - Fax:504-891-3217
Practice Address - Street 1:2820 NAPOLEON AVE
Practice Address - Street 2:#650
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115
Practice Address - Country:US
Practice Address - Phone:504-899-1114
Practice Address - Fax:504-891-3217
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA015638207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1330779Medicaid
B61360Medicare UPIN
LA1330779Medicaid