Individual
SAMUEL GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8391 N DAVIS HWY, PENSACOLA, FL 32514
(850) 494-6000
(866) 947-4181
Mailing address
8391 N DAVIS HWY, PENSACOLA, FL 32514-6048
(850) 494-6000
(866) 947-4181
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
19219
MS
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME61914
FL
2081P0004X
Spinal Cord Injury Medicine Physician
19219
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2554707
—
MS
Enumeration date
10/12/2005
Last updated
12/07/2018
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