Grant, Thomas Russell
Grant, Thomas Russell is an individual health care provider with primary practice located at 825 Fairfax Ave , Norfolk VA 23507-1914. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Grant, Thomas Russell can be contacted via phone (757) 446-5955.Contact Information
Primary practice address
825 Fairfax Ave
Norfolk VA 23507-1914
Phone: (757) 446-5955
Fax: (757) 446-5196
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0101036347 | Virginia |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | 0101036347 | Virginia |
Profile Details
| NPI number | 1427022169 |
|---|---|
| LBN Legal business name | Grant, Thomas Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 16th, 2006 |
| Last updated | Jan 23rd, 2009 - about 15 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 | 1427022169 | NPPES |
| Virginia | Other | PAR | VIRGINIA PREMIER HEALTH |
| Virginia | MEDICAID | 005612632 | VIRGINIA PREMIER HEALTH |
| Virginia | Other | 0526K | VIRGINIA PREMIER HEALTH |
| Virginia | Other | 081925 | VIRGINIA PREMIER HEALTH |
| Virginia | Other | PAR | VIRGINIA PREMIER HEALTH |
| Virginia | Other | 11025 | VIRGINIA PREMIER HEALTH |
| Virginia | MEDICAID | 890526K | VIRGINIA PREMIER HEALTH |
| Virginia | Other | PAR | VIRGINIA PREMIER HEALTH |
| Virginia | MEDICAID | 005624151 | VIRGINIA PREMIER HEALTH |
| Virginia | Other | PAR | VIRGINIA PREMIER HEALTH |
| Virginia | Other | PAR | VIRGINIA PREMIER HEALTH |
| Virginia | Other | -002 -003 | VIRGINIA PREMIER HEALTH |
| Virginia | Other | 2180424 | VIRGINIA PREMIER HEALTH |
| Virginia | Other | PAR | VIRGINIA PREMIER HEALTH |
| Virginia | Other | PAR | VIRGINIA PREMIER HEALTH |
| Virginia | Other | PAR | VIRGINIA PREMIER HEALTH |
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