Individual
EDWARD KEITH GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
(478) 254-5463
Mailing address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
(478) 254-5463
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004120
GA
363A00000X
Physician Assistant
4120
GA
363AS0400X
Surgical Physician Assistant
Primary
4120
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
542228866E
—
GA
01
—
P00758778
MEDICARE RAILROAD
GA
Enumeration date
06/21/2005
Last updated
01/26/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us