Grider, Kenny M.

Grider, Kenny M. is an sole proprietor health care provider with primary practice located at 1805 W University Blvd , Durant OK 74701-3011. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Grider, Kenny M. can be contacted via phone (580) 920-0300.

Contact Information

Primary practice address
1805 W University Blvd Durant OK 74701-3011
Phone: (580) 920-0300
Fax: (580) 920-0581
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X DO3262 Oklahoma

Profile Details

NPI number 1245216191
LBN Legal business name Grider, Kenny M.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 21st, 2005
Last updated Sep 15th, 2020 - about 5 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 1245216191 NPPES
Oklahoma MEDICAID 100136800A
Oklahoma Other 200022524

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