# GRIMBALL & RICHERT CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194717892
- **Authorized official:** DR. ROGER G GRIMBALL MD (PRESIDENT)
- **Authorized official phone:** (337) 527-6301

## Contact information

- **Practice address:** 920 1ST AVE, SULPHUR, LA 70663-3425
- **Practice address phone:** (337) 527-6301
- **Practice address fax:** (337) 527-9194
- **Mailing address:** 920 1ST AVE, SULPHUR, LA 70663-3425
- **Mailing address phone:** (337) 527-6301
- **Mailing address fax:** (337) 527-9194

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/18/2005
- **Last updated:** 08/22/2020