Individual
RUTH ANNE GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7043
(850) 474-9060
Mailing address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7043
(850) 474-9060
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD30321
ME
207L00000X
Anesthesiology Physician
Primary
ME102001
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000328600
—
FL
05
—
103990
—
AL
05
—
131403
—
AL
01
—
592-03468
BLUE CROSS BLUE SHIELD
AL
01
—
592-15483
BLUE CROSS BLUE SHIELD
AL
01
—
61672
BLUE CROSS BLUE SHIELD
FL
01
—
P00667073
MEDICARE RAILROAD
—
Enumeration date
06/24/2008
Last updated
05/01/2026
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