Individual
DR. SCOTT MARTIN GRIGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 W MAIN ST, SUITE 100, IDABEL, OK 74745-4654
(580) 579-3385
Mailing address
ONE WEST MAIN, SUITE 100, IDABEL, OK 74745-4655
(580) 286-1101
(580) 286-5566
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25241
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200097850A
—
OK
Enumeration date
11/03/2006
Last updated
10/13/2015
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