Individual
DR. THOMAS JORDAN GRILLOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1161 21ST AVE S STE CCC 1118, NASHVILLE, TN 37232-3124
(615) 343-1188
Mailing address
719 THOMPSON LN STE 30330, NASHVILLE, TN 37204-4701
(615) 322-3000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
58655
TN
2085R0202X
Diagnostic Radiology Physician
94-08730
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/21/2014
Last updated
05/14/2019
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