Individual
MR. GRANT D ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3110 SW 89TH ST STE 102, OKLAHOMA CITY, OK 73159-7919
(405) 703-4950
(405) 703-4955
Mailing address
14024 QUAIL POINTE DR, OKLAHOMA CITY, OK 73134-1006
(405) 419-8447
(405) 419-7745
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1204
OK
363AS0400X
Surgical Physician Assistant
Primary
1204
OK
Other
Enumeration date
02/03/2006
Last updated
07/24/2015
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