Organization
JERRY H GRANT, M.D., P.A.
Active
Other names
GrantMED
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY HENRY GRANT M.D. (OWNER/PHYSICIAN)
(870) 862-2285
Entity
Organization
Contact information
Practice address
104 E GROVE ST, EL DORADO, AR 71730
(870) 862-2285
(870) 862-2289
Mailing address
104 E GROVE ST, EL DORADO, AR 71730-4607
(870) 862-2285
(870) 862-2289
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
E-0952
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080128979
RAILROAD MEDICARE
AR
05
—
130237001
—
AR
Enumeration date
12/07/2010
Last updated
08/07/2019
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