Individual
DAXTON THANE GRIGSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
19600 E ROSS ST, TAHLEQUAH, OK 74464-0545
(539) 234-1000
Mailing address
4502 E 41ST ST, TULSA, OK 74135-2536
(918) 660-3842
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5469
OK
Other
Enumeration date
08/13/2022
Last updated
07/15/2025
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