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Organization

LEE GRIMM, M.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEE M GRIMM M.D. (OWNER)
(423) 854-0001
Entity
Organization

Contact information

Practice address
7580 CLARINGTON CV, SUITE 3, SOUTHAVEN, MS 38671-5657
(423) 854-0001
(423) 854-0002
Mailing address
3101 BROWNS MILL RD, SUITE 6, JOHNSON CITY, TN 37604-4100
(423) 854-0001
(423) 854-0002

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12705
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DD0811
RAILROAD MEDICARE
MS
Enumeration date
11/14/2007
Last updated
03/12/2008
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