Individual
JON R GRIGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
ST. JAMES & THIRD STREET, SUITE 103A, MANSFIELD, PA 16933
(570) 662-7600
(570) 662-7726
Mailing address
1873 SHUMWAY HILL RD, WELLSBORO, PA 16901-6840
(570) 724-5766
(570) 724-6757
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD043534E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011677250013
—
PA
05
—
0011677250014
—
PA
Enumeration date
10/16/2006
Last updated
03/05/2008
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