Individual
GRANT JEFFREY RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 NW OBRIEN RD, LEES SUMMIT, MO 64063-1806
(816) 287-1528
(343) 503-0640
Mailing address
601 NW OBRIEN RD, LEES SUMMIT, MO 64063-1806
(816) 287-1528
(343) 503-0640
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2024001206
MO
Other
Enumeration date
04/10/2019
Last updated
06/27/2024
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