Individual
MARC B GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
708 S COEUR D ALENE LN, PAYSON, AZ 85541-5662
(928) 468-1337
(928) 468-1339
Mailing address
708 S COEUR D ALENE LN, PAYSON, AZ 85541-5662
(928) 468-1337
(928) 468-1339
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
1609
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285280
—
AZ
01
—
H20777190
BXBS
AZ
Enumeration date
02/01/2006
Last updated
09/15/2012
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