Organization
MICHAEL J. GROGAN M.D. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOSEPH GROGAN M.D. (OWNER)
(859) 586-0111
Entity
Organization
Contact information
Practice address
51 CAVALIER BLVD, SUITE 230, FLORENCE, KY 41042-3966
(859) 586-0111
Mailing address
51 CAVALIER BLVD, SUITE 230, FLORENCE, KY 41042-3966
(859) 586-0111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21980
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7395
MEDICARE PTAN
KY
Enumeration date
04/29/2008
Last updated
08/11/2008
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