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Organization

SCOTT GRIGORY, MD, PC

Active
Other names
My Doctor
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SCOTT MARTIN GRIGORY M.D. (OWNER)
(580) 579-3385
Entity
Organization

Contact information

Practice address
1 W MAIN ST, SUITE 100, IDABEL, OK 74745-4654
(580) 579-3385
Mailing address
1 W MAIN ST, SUITE 100, IDABEL, OK 74745-4654
(580) 579-3385

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25241
OK
208D00000X
General Practice Physician
25241
OK
261QU0200X
Urgent Care Clinic/Center
25241
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200097850A
OK
Enumeration date
01/12/2015
Last updated
10/03/2017
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