Individual
DR. THOMAS ARCHIE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9392 STONEBRIAR CIR, SHREVEPORT, LA 71115-3728
(318) 795-0406
Mailing address
9392 STONEBRIAR CIR, SHREVEPORT, LA 71115-3728
(318) 795-0406
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
09226
LA
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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