Individual
DR. ROGER G GRIMBALL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 1ST AVE, SULPHUR, LA 70663-3425
(337) 527-6301
(337) 527-9194
Mailing address
920 1ST AVE, SULPHUR, LA 70663-3425
(337) 527-6301
(337) 527-9194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
011615
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1121177
—
LA
Enumeration date
08/12/2005
Last updated
07/08/2007
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