Grogg, Jerod B
Grogg, Jerod B is an individual health care provider with primary practice located at 7740 Washington Village Dr Ste 110 , Dayton OH 45459-3994. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Grogg, Jerod B can be contacted via phone (937) 439-4145.Contact Information
Primary practice address
7740 Washington Village Dr Ste 110
Dayton OH 45459-3994
Phone: (937) 439-4145
Fax: (937) 439-4371
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 50001994 | Ohio |
Profile Details
| NPI number | 1639203441 |
|---|---|
| LBN Legal business name | Grogg, Jerod B |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2007 |
| Last updated | Feb 2nd, 2021 - about 3 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 | 1639203441 | NPPES |
| Ohio | MEDICAID | 0085267 |
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