Organization
DEGARA APP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES GRIMES (CFO)
(615) 551-6611
Entity
Organization
Contact information
Practice address
401 W GREENLAWN AVE, LANSING, MI 48910
(517) 975-6000
(904) 559-4370
Mailing address
PO BOX 4458, DEPT # 206, HOUSTON, TX 77210-4458
(855) 246-8607
(629) 216-0568
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/14/2016
Last updated
01/27/2023
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