Individual
JAY SAMUEL GRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, PHD
Contact information
Practice address
310 S LIMESTONE, SUITE 100A, LEXINGTON, KY 40508-3008
(859) 323-7246
(859) 257-6612
Mailing address
2333 ALUMNI PARK PLZ, SUITE 200, LEXINGTON, KY 40517-4012
(859) 257-7910
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
02674
KY
207LP2900X
Pain Medicine (Anesthesiology) Physician
02674
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64078181
—
KY
Enumeration date
09/27/2006
Last updated
09/05/2012
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