# DR. JONATHAN R GRANT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1912064577
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | 242010 | MA | — |
| 207Y00000X | Otolaryngology Physician | 47898-020 | WI | — |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | MD60187241 | WA | Yes |
| 2082S0099X | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | MD60187241 | WA | — |
| 208600000X | Surgery Physician | MD60187241 | WA | — |
| 2086S0122X | Plastic and Reconstructive Surgery Physician | MD60187241 | WA | — |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 03/15/2012