Individual
DR. KEVIN N GROOM
Active
Individual
DR. KEVIN N GROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
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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