Gridley, Gary Douglas

Gridley, Gary Douglas is an individual health care provider with primary practice located at 269 S Candy Ln , Cottonwood AZ 86326-4158. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Gridley, Gary Douglas can be contacted via phone (928) 639-6150.

Contact Information

Primary practice address
269 S Candy Ln Cottonwood AZ 86326-4158
Phone: (928) 639-6150
Fax: (928) 639-6561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD00030603 Washington
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 30200 Arizona

Profile Details

NPI number 1336120260
LBN Legal business name Gridley, Gary Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Oct 18th, 2022 - about 2 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 1336120260 NPPES
Washington Other 8930278 CRIME VICTIMS PGM
Washington Other 5647GR CRIME VICTIMS PGM
Washington Other 0181547 CRIME VICTIMS PGM
Washington MEDICAID 8312498 CRIME VICTIMS PGM

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