Individual
HERBERT GALEN GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 W 8TH ST, FORT SCOTT, KS 66701-2403
(620) 223-5032
(620) 223-5071
Mailing address
701 W 8TH ST, FORT SCOTT, KS 66701-2403
(620) 223-5032
(620) 223-5071
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
04-20707
KS
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MDR6E98
MO
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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