Individual
KENNETH GRIGSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2450 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2179
(702) 877-8660
(702) 877-5140
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 877-8661
(702) 877-5140
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
11862
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100510148
—
NV
01
—
1417983792
MEDI-CAL
CA
05
—
1417983792
—
NV
05
—
1417983792
—
WA
05
—
168644001
—
AR
05
—
1770556037
—
UT
05
—
192828
—
AZ
05
—
63334526
—
CO
05
—
8480675
—
WA
01
—
P00618862
RAILROAD MEDICARE
—
Enumeration date
06/25/2006
Last updated
02/26/2026
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