Simmons, Grant Pegram

Simmons, Grant Pegram is an individual health care provider with primary practice located at 400 Berywood Trl Nw Ste B , Cleveland TN 37312-5288. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Simmons, Grant Pegram can be contacted via phone (423) 472-3201.

Contact Information

Primary practice address
400 Berywood Trl Nw Ste B Cleveland TN 37312-5288
Phone: (423) 472-3201
Fax: (423) 476-4949
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD0000045559 Tennessee

Profile Details

NPI number 1982751921
LBN Legal business name Simmons, Grant Pegram
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Jun 24th, 2014 - about 10 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 1982751921 NPPES
Mississippi MEDICAID 00016605
Mississippi MEDICAID 1148245

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