Individual
JESSE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2701 N ROCKWELL AVE, BETHANY, OK 73008-5246
(405) 789-4150
(405) 789-1067
Mailing address
2701 N ROCKWELL AVE, BETHANY, OK 73008-5246
(405) 789-4150
(405) 789-1067
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35971
OK
Other
Enumeration date
06/11/2020
Last updated
07/10/2023
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