Organization
JEFFREY S. GRANT, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY S GRANT M.D. (CEO)
(505) 325-0072
Entity
Organization
Contact information
Practice address
608 E COMANCHE ST, FARMINGTON, NM 87401-6815
(505) 325-0072
(505) 327-1739
Mailing address
PO BOX 677, FARMINGTON, NM 87499-0677
(505) 325-0072
(505) 327-1739
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
99-216
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A5179
—
NM
Enumeration date
10/11/2006
Last updated
05/13/2011
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