Individual
JOSEPH ALEXANDER DE GRUY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
151 E METRO DR STE 201, FLOWOOD, MS 39232-4405
(601) 973-1680
(601) 973-1681
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
31594
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
MS
Other
Enumeration date
06/11/2018
Last updated
07/11/2023
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