Individual
DR. RAYMOND FREDERIC GRENFELL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
971 LAKELAND DR, ST. DOMINIC WEST TOWER SUITE 450, JACKSON, MS 39216-4643
(601) 948-5158
(601) 326-4265
Mailing address
971 LAKELAND DR, ST. DOMINIC WEST TOWER SUITE 450, JACKSON, MS 39216-4643
(601) 948-5158
(601) 949-6058
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
21031
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780902155
GROUP NPI NUMBER
MS
Enumeration date
05/11/2007
Last updated
05/11/2023
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