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Individual

DR. KEVIN N GROOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
890 SOUTH PALAFOX STREET, SUITE 300, PENSACOLA, FL 32502
(850) 433-1656
(850) 433-1996
Mailing address
890 SOUTH PALAFOX STREET, SUITE 300, PENSACOLA, FL 32502
(850) 433-1656
(850) 433-1996

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
1138
AL
103G00000X
Clinical Neuropsychologist
Primary
PY6326
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
510-01535
BCBS OF AL DOTHAN AL
AL
01
54648
BCBS NUMBER
FL
01
59033603
BCBS AL GROUP
AL
Enumeration date
10/02/2006
Last updated
07/19/2023
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