Grantham, Jonathan L
Grantham, Jonathan L is an individual health care provider with primary practice located at 444 Four States Dr Suite 1, Galena KS 66739-4324. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Grantham, Jonathan L can be contacted via phone (620) 783-4441.Contact Information
Primary practice address
444 Four States Dr Suite 1
Galena KS 66739-4324
Phone: (620) 783-4441
Fax: (620) 783-4090
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 107822 | Missouri |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 0433509 | Kansas |
Profile Details
| NPI number | 1386671238 |
|---|---|
| LBN Legal business name | Grantham, Jonathan L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2006 |
| Last updated | Dec 30th, 2011 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386671238 | NPPES |
| Missouri | MEDICAID | 207974510 | |
| Missouri | MEDICAID | 100404800G | |
| Missouri | MEDICAID | 100404800C |
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