Individual
DR. JONATHAN DOUGLAS GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-3888
(801) 442-3263
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 507-3888
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
10124565-1205
UT
2085R0001X
Radiation Oncology Physician
2015-00676
NC
2085R0001X
Radiation Oncology Physician
38030
SC
2085R0001X
Radiation Oncology Physician
AU3354177
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861738189
—
NC
05
—
GA1773
—
SC
Enumeration date
12/13/2012
Last updated
01/12/2017
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