Grantham, Roy N
Grantham, Roy N is an individual health care provider with primary practice located at 4221 S Western Ave 2010, Oklahoma City OK 73109-3447. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Grantham, Roy N can be contacted via phone (405) 231-0540.Contact Information
Primary practice address
4221 S Western Ave 2010
Oklahoma City OK 73109-3447
Phone: (405) 231-0540
Fax: (405) 644-5309
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 16465 | Oklahoma |
Profile Details
| NPI number | 1568457265 |
|---|---|
| LBN Legal business name | Grantham, Roy N |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Dec 4th, 2014 - about 10 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 | 1568457265 | NPPES |
| Oklahoma | Other | 5765290 | AETNA |
| Oklahoma | Other | 060052653 | AETNA |
| Oklahoma | MEDICAID | 100122170A | AETNA |
| Oklahoma | Other | 125309100 | AETNA |
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