Individual
DR. BRIAN J GRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10240 SAN JOSE BLVD, JACKSONVILLE, FL 32257-6203
(904) 262-9024
(904) 268-9534
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS11911
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS11911
STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
FL
Enumeration date
09/10/2009
Last updated
11/19/2024
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