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Individual

DR. GRENVILLE JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
361 OLD BELGRADE RD, AUGUSTA, ME 04330-8058
(207) 873-6034
(207) 872-9136
Mailing address
PO BOX 608, WATERVILLE, ME 04903-0608
(207) 873-6034
(207) 872-9136

Taxonomy

Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
015280
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
038732
BCBS
ME
05
305950099
MA
01
MM8492
MEDICARE
MA
Enumeration date
09/14/2006
Last updated
02/04/2014
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