Grant, Marc B

Grant, Marc B is an individual health care provider with primary practice located at 708 S Coeur D Alene Ln , Payson AZ 85541-5662. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Grant, Marc B can be contacted via phone (928) 468-1337.

Contact Information

Primary practice address
708 S Coeur D Alene Ln Payson AZ 85541-5662
Phone: (928) 468-1337
Fax: (928) 468-1339
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X 1609 Arizona

Profile Details

NPI number 1700857125
LBN Legal business name Grant, Marc B
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2006
Last updated Sep 15th, 2012 - about 13 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 1700857125 NPPES
Arizona Other H20777190 BXBS
Arizona MEDICAID 285280 BXBS

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