Individual
DR. JORDAN H GRIZZLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
346 DEEP SOUTH FARM RD STE A, BLAIRSVILLE, GA 30512-2218
(706) 745-9417
(706) 896-0877
Mailing address
346 DEEP SOUTH FARM RD STE A, BLAIRSVILLE, GA 30512-2218
(706) 745-9417
(706) 896-0877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
98769
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003279288C
—
GA
Enumeration date
04/09/2022
Last updated
09/15/2025
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