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Individual

DR. LEON M GRIGORYEV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 LAYFAIR DR, SUITE 100, FLOWOOD, MS 39232-9717
(601) 936-8801
(601) 936-8808
Mailing address
1 LAYFAIR DR, SUITE 100, FLOWOOD, MS 39232-9717
(601) 936-8801
(601) 936-8808

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
20728
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
407739
WINDSOR MEDICARE
MS
Enumeration date
09/27/2006
Last updated
04/08/2010
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