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Individual

ROBERT THOMAS GRISSOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8080 BLUEBONNET BLVD, STE 3000, BATON ROUGE, LA 70810-7827
(225) 766-8100
(225) 766-0079
Mailing address
8080 BLUEBONNET BLVD, STE 3000, BATON ROUGE, LA 70810-7827
(225) 766-8100
(225) 766-0079

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
05411R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1338036
LA
Enumeration date
06/26/2006
Last updated
05/19/2010
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