Individual
DR. GEORGE R GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 HEALTH CENTER DRIVE, MATTOON, IL 61938-0372
(217) 258-2551
(217) 258-2256
Mailing address
320 E HIGHWAY 50, O FALLON, IL 62269-2704
(618) 624-3368
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2001022239
MO
Other
Enumeration date
07/24/2006
Last updated
03/02/2012
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