Individual
DANNETTA GRISHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 WERNER ST, HOT SPRINGS, AR 71913-6406
(501) 622-1120
(501) 622-1199
Mailing address
PO BOX 241035, LITTLE ROCK, AR 72223-0001
(501) 258-3073
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C7699
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117633001
—
AR
01
—
539876972
MEDICARE LINKED
—
Enumeration date
04/28/2006
Last updated
04/10/2008
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