Grissom, Samuel

Grissom, Samuel is an individual health care provider with primary practice located at 8391 N Davis Hwy , Pensacola FL 32514. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Spinal Cord Injury Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Grissom, Samuel can be contacted via phone (850) 494-6000.

Contact Information

Primary practice address
8391 N Davis Hwy Pensacola FL 32514
Phone: (850) 494-6000
Fax: (866) 947-4181
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Spinal Cord Injury Medicine 2081P0004X 19219 Mississippi
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 19219 Mississippi
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X ME61914 Florida

Profile Details

NPI number 1205824265
LBN Legal business name Grissom, Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Dec 7th, 2018 - about 6 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 1205824265 NPPES
Mississippi MEDICAID 2554707

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