Grant, Courtney L
Grant, Courtney L is an sole proprietor health care provider with primary practice located at 725 Jesse Jewell Pkwy Se , Gainesville GA 30501-3834. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is her primary health care specialty. Grant, Courtney L can be contacted via phone (678) 207-4000.Contact Information
Primary practice address
725 Jesse Jewell Pkwy Se
Gainesville GA 30501-3834
Phone: (678) 207-4000
Fax: (770) 531-2435
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 0116025753 | Virginia |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 86237 | Georgia |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 86237 | Georgia |
Profile Details
| NPI number | 1033557459 |
|---|---|
| LBN Legal business name | Grant, Courtney L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 7th, 2013 |
| Last updated | Feb 7th, 2022 - about 2 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 | 1033557459 | NPPES |
| Georgia | MEDICAID | 003235364G | |
| Georgia | MEDICAID | 003235364D | |
| Georgia | MEDICAID | 003235364B | |
| Georgia | MEDICAID | 003235364C | |
| Georgia | MEDICAID | 003235364F | |
| Georgia | MEDICAID | 003235364H | |
| Georgia | MEDICAID | 003235364A | |
| Georgia | MEDICAID | 003235364E |
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