Grimm, Leander M

Grimm, Leander M is an sole proprietor health care provider with primary practice located at 401 Southcrest Circle Suite 204, Southaven MS 38671. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Grimm, Leander M can be contacted via phone (662) 349-0311.

Contact Information

Primary practice address
401 Southcrest Circle Suite 204 Southaven MS 38671
Phone: (662) 349-0311
Fax: (662) 349-0121
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 12705 Mississippi
Allopathic & Osteopathic Physicians / Surgery 208600000X 20507 Tennessee

Profile Details

NPI number 1598877805
LBN Legal business name Grimm, Leander M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 31st, 2006
Last updated Oct 20th, 2016 - about 9 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 1598877805 NPPES
Tennessee MEDICAID 3726800
Tennessee MEDICAID 00111800
Tennessee Other 4091934

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