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Individual
STEPHEN G GRILLOT
Active
Individual
STEPHEN G GRILLOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-25303
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100237500F
—
KS
05
—
100237500O
—
KS
01
—
P00829200
RAILROAD THRU ST CATS
KS
Enumeration date
09/25/2006
Last updated
11/20/2012
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