Individual
NATALIE BANKS GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1515 NE LAWRIE TATUM RD, LAWTON, OK 73507-3002
(580) 354-5000
Mailing address
5 SAINT VINCENT CIR, STE 210, LITTLE ROCK, AR 72205-5416
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0116025854
VA
208600000X
Surgery Physician
33688
OK
2086S0127X
Trauma Surgery Physician
Primary
T2020-507
AR
Other
Enumeration date
06/07/2013
Last updated
10/26/2020
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