GLENN GERARD RUSSO M.D.
NPI 1083683445
Dermatology - Procedural Dermatology in Gretna, LA

Active since March 16, 2006
120 MEADOWCREST ST, SUITE 160, GRETNA, LA 70056(504) 391-7620(504) 391-7624 Get Directions Write a Review

NPPES record last updated: February 3, 2010. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Glenn Gerard Russo M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLENN GERARD RUSSO M.D. (NPI 1083683445) is an individual procedural dermatology provider in Gretna, Louisiana, licensed in Louisiana (017336) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1083683445
Entity TypeIndividualMale
Primary Taxonomy207NS0135X
Provider Legal NameGLENN GERARD RUSSOCredential: M.D.
Location Address120 MEADOWCREST ST, SUITE 160Gretna, LA 70056-5255
Mailing Address600 Olive AveHarvey, LA 70058-4456 · (504) 366-5035
Fax(504) 391-7624
Sole ProprietorNo
Enumeration DateMarch 16, 2006
Last NPPES UpdateFebruary 3, 2010
NPI 1083683445 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
License Licensed in LA · 017336
Definition

Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

120 MEADOWCREST ST, Gretna, LA 70056

Other Identifiers 1

Medicare ID-Type Unspecified50622LA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist
120 MEADOWCREST ST, STE 380
GRETNA, LA 70056
Psychiatry & Neurology (Neurology)
120 MEADOWCREST ST, STE 420
GRETNA, LA 70056
Psychiatry & Neurology (Neurology)
120 MEADOWCREST ST, STE 420
GRETNA, LA 70056
Dermatology (Procedural Dermatology)
120 MEADOWCREST ST, SUITE 160
GRETNA, LA 70056
Dermatology (Procedural Dermatology)
120 MEADOWCREST ST, SUITE 160
GRETNA, LA 70056
Otolaryngology
120 MEADOWCREST ST, SUITE 200
GRETNA, LA 70056
Otolaryngology
120 MEADOWCREST ST, SUITE 200
GRETNA, LA 70056
Obstetrics & Gynecology
120 MEADOWCREST ST, SUITE 240
GRETNA, LA 70056

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083683445, enumerated as an "individual" on March 16, 2006.

The provider is located at 120 MEADOWCREST ST SUITE 160 GRETNA, LA 70056 and the phone number is (504) 391-7620.

Dermatology with taxonomy code 207NS0135X and a focus in Procedural Dermatology.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.