Individual
DR. ALFRED GRANSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., LLC
Contact information
Practice address
70 MADISON RD, MANSFIELD, OH 44905-2831
(419) 589-9700
(419) 589-2731
Mailing address
70 MADISON RD, MANSFIELD, OH 44905-2831
(419) 589-9700
(419) 589-2731
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35072595G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000142322
ANTHEM BC/BS OF OHIO
OH
05
—
2136683
—
OH
01
—
9387391
MEDICARE GROUP
OH
01
—
DQ1487
RAILROAD MEDICARE INDIVIDUAL
OH
01
—
P00818354
RAILROAD MEDICARE GROUP
OH
Enumeration date
09/25/2006
Last updated
08/04/2011
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