Individual
DR. JAMES M GRISOLANO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
999 GUARDIAN WAY, COOKEVILLE, TN 38501-1722
(931) 650-4100
(931) 650-4101
Mailing address
999 GUARDIAN WAY, COOKEVILLE, TN 38501-1722
(931) 650-4100
(931) 650-4101
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD0000016505
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00130863
RAILROAD MEDICARE
TN
Enumeration date
05/31/2005
Last updated
01/03/2023
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