Individual
MR. ROBERT W GRIMES JR.
Active
Individual
MR. ROBERT W GRIMES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1500671
KS
363AS0400X
Surgical Physician Assistant
Primary
15-00671
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-00671
STATE PA LICENSE NUMBER
KS
Enumeration date
12/21/2005
Last updated
12/03/2021
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